severity grade: 3
A recurrence of the 2004 injury. Started to surface back in August and has grown progressively worse. A three week layoff from running from mid November to early December was unsuccessful in resolving the problem (I probably should have been taking aspirin or ibuprofen at the same time).
12/11/06 update: Saw Dr. Nippert today (podiatrist). He took x-rays of my foot which didn't show anything significant. On the plus side, he said he saw no evidence of any recent calcification/bleeding or cracking around my heel spurs. He also checked my orthotics and said they still fit properly.
It appears this bout of PF is merely due to inflammation of the tendon. He prescribed an anti-inflammatory (Naproxen). I am scheduled to see him again late next week when he will do some ultrasonic imaging of the tendon to check it for inflammation. If the anti-inflammatory doesn't work the two options appear to be a cortisone injection (which I'm not crazy about but he didn't think carried much if any risk) and ultrasound therapy. The ultrasound is a relatively new approach to treating PF - it helps rid the tendon of scar tissue and promote new tissue growth.
12/21/06 Update - Ultrasound imaging of the plantar fascia tendon showed it to be 5.6 mm thick compared to about 4 mm for a healthy one. The podiatrist said this is getting close to the level where you can expect to have some ongoing problems. I'll finish up the course of anti-inflammatories then see him again a week later. At that point he'll decide whether ultrasound therapy is required.
1/22/07 update: Had my last visit with the podiatrist and since the heel is not getting sore as I up my mileage, we decided to let things go for now. If it gets bad again, then I'll pursue some more aggressive treatment options. He did adjust my dress orthotics slightly (raised the left heel) but unfortunately this was the 1st visit where I didn't bring my running orthotics so they remain unadjusted.
One month course of anti-inflammatories (Naproxen) probably hastened the recovery but I think rest and stretching helped most. Did the plantar fascia stretch (bending toes forward) before getting out of bed each morning.