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Plantar Fasciitis : The recovery is complete

bernie-plantar-fascia

Without wanting to jinx anything, I’ve thankfully managed to recover from my plantar fasciitis, and I thought I would (finally) complete my page about plantar fasciitis.

I hope anyone who has or suffers from plantar fasciitis finds it useful!

In other news, tomorrow is Day 1 of marathon training. Gulp…

Bernie,

Get Going, Get Running!

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Plantar fasciitis : the recovery continues

With seemingly more episodes than the Star Wars saga you might be getting sick of my Plantar Fasciitis posts, however I hope this post is able to be of some use to you in your recovery as well.

Before we get ahead of ourselves – I am not fully recovered – it is a long process. I am not yet at the ability level I was before my injury, but I am getting closer! For instance, I am back to training with my Australian Rules Football team (about 5km of Fartlek style training per session) and have even played two competitive matches. However, I still get pain if I stand for too long in unsupportive work shoes and I still have noticeable tightness in my plantar fascia after I wake. The shooting pain through the heel in the first steps of the morning is gone though. Thank heavens!

I am also happy to report that I was able to spend the long weekend in sunny Istanbul (lucky me!) walking around all day and night, without too much in the way of whingeing from my plantar fascia. Sure, it got tight and a little tender, but static stretches on my calves and Achilles and a couple of Ibuprofen were able to sort it out enough that I could be on my feet for most of the day, for 3 days in a row.

Moving swiftly on to the subject at hand, I credit my recovery so far to:

  1. no running during the acute phase, following my diagnosis
  2. use of massage, ice therapy and ibuprofen (no more than recommended dosage) to reduce inflammation
  3. a strong focus on static stretches to elongate calf muscles, Achilles heel and the plantar fascia itself
  4. in the sub-acute phase the use of cross-training to maintain cardio fitness, a gradual build-up to running, and the continuation of my static stretching routine
  5. Time. Most injuries react positively to time, and I haven’t pushed the boundaries in trying to get back to running and it think this has helped

Now that I am getting much less pain and am returning to running, I am trying to strengthen my feet with exercises to make sure my foot musculature is up to the rigours of  running. I am now 22 weeks out from a marathon and it’s about time to get running! While looking for exercises to help strengthen my foot and lower limbs I stumbled upon some great exercises on the Vibram Five Fingers website. The exercises are actually for assisting in transitioning from ‘regular’ running to ‘barefoot’ running; however I think that foot and lower limb strength are just as important for regular runners and the exercises are certainly suitable for runners who still wear shoes. Certainly they seem to be helping me with my foot strength.

Here are the Vibram foot exercises I have been doing:

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Plantar Fasciitis : from the acute phase to the recovery phase

Good news! My plantar fasciitis is improving and I am past the acute phase and into the recovery phase.

During the early part of the acute phase the main focus was to control inflammation and decrease pain. I rested my foot and was off running for 7 days. I also kept walking to short distances. I used Ibuprofen to reduce swelling and help with the pain, as well as cold massage, using a frozen water bottle or a cold can of soft-drink and rolling my foot on top of the bottle over the painful area. Just take a frozen water bottle and massage your foot, here’s an instructional video:

My physiotherapist worked on my calf muscles to release tension and reduce stress on my plantar fascia, and prescribed stretches to relax the plantar fascia and elongate my calf and Achilles. In the latter part of the acute phase, I focussed on my stretches and massage to ease up my calves and stretch my Achilles, continuing foot stretches and using tennis and golf-ball massage to really get into the plantar fascia. Here’s a video showing the technique I used for my tennis ball and golf ball massage:

You can also ‘double up’ with cold and massage to help alleviate symptoms. To do this I put a couple of golf balls in the freezer and then used them to massage my foot as shown in the tennis ball video.

Active Rest: Don’t recover on your couch!

‘Active rest’ is key during the latter part of the acute phase so you don’t lose fitness and strength, so it’s important to find alternative forms of training that keep your fitness levels up but do not stress the fascia. For my active rest I got back on the bike so my cardio fitness was maintained, though I have read that a lot of people choose swimming as it has no impact. Whatever you choose, make sure it is a low or nil impact exercise that will get blood and oxygen flowing, which assists to speed up your body’s repair.

As it has now been a few weeks and the condition is improving I have also started football training again as I find the ‘fartlek’ type training on grass good for my cardio fitness, without the impact of running on pavement or the long repetitive straining that comes with long running on the pavement. I have found taping for support and compression to be useful too. Here is a video which shows you how to replicate the taping that my physio did for me. I do the first part of the taping with the anchor strap and cross straps, the optional ‘top of foot’ taping restricts my movement too much and I don’t find it necessary.

There are other taping techniques which provide even more support, however I wouldn’t recommend it on the basis that if you need that much taping on your foot just to complete ‘active rest’ activities, then your active rest activity is far too stressful, or you are still too early in the acute phase to be doing active rest.

Onwards and upwards: the recovery phase

Looking ahead to the recovery phase I have been doing some research and also speaking to my physiotherapist as to how best to recover and ensure an ongoing reduction in the stress on my plantar fascia. This mainly revolves around stretches and exercises to elongate my calves while keeping them strong, and to keep my plantar fascia elongated. However, while doing some research on the condition the other night I found out two keys things which can exacerbate the problem which were outside of the physical recovery processes I am undertaking:

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Plantar Fasciitis: Or ‘the reason I stopped running and started talking’…

As I mentioned in one of my earlier posts, I first started this blog because instead of going running I found myself injured and talking about running instead. As you’ve guessed from the title of this post, an attack of Plantar Fasciitis has laid me up for the last four weeks or so. (GFs eyes roll due to excessive melodrama…). Ok, not laid up. Just not running and generally being mopey and looking for sympathy from aforementioned GF. I’ll explain later why sympathy is currently hard to come by…

So how can this post help you? Well, I made two basic mistakes which you should learn from:

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