L Foot, Plantar Fasciitis
2006-11-03 – 2007-08-28
Grade: 1
I guess I should try to document this retrospectively (as of 11/9), and going forward.
Pain onset, left foot, mid-september, coincident with drastic volume increase relating to 2 course settings on top of normal volume trending up, plus perhaps, in retrospect, bum shoes.
Ignored the pain, it was so minor compared to other aches and pains, and didn't get worse. Did not even think it was anything to care about.
10/1: debiliting patellafemoral pain snydrome (runner's knee) in opposite knee, attributed to volume and bum shoes.
thru Oct, gradual recovery from the PFS, running until pain offset; not cognizant of whether the PF was present or not.
11/2: felt PFS was generally resolving under the reduced volume regimen, and had mapped out a weekly plan to be at normal volume by year, end, yet had noticed the PF pain and decided not to ignore it based on the warnings on AP and other injury fora that I stumbled on during the PFS research.
11/3: self-diagnosed PF based on web resources, but pain seemed too mild to care about. Did not have morning pain or stabbing pain. Could run fine, with dull pain thru the day, not during run.
Visit podiatrist; dx confirmed, rx --
PT for stretching/ultrasound
OTC inserts (NB motion control)
custom orthotics on failure of OTC
in home stretching
shoe perscription (Asiacs super cushioned, or the like)
feldene (NSAID)
the frozen bottle ice thing
moleskin on bottom of foot
no running
expected resolution, 2-3 weeks.
underlying problem is poor flexibility around the ankle; normal ROM 10%, mine basically 0. Only cure is surgery to increase the length of the achilles, but stretching may improve ROM a point or so.
Other factors -- I hate shoes, and pretty much walk everywhere barefoot (including at work, which I sure has the dress code police up in arms). Do aerobics barefoot also.
A few hours on the moleskin, the pain was gone, but pressure exam of the ligiment reveals it is still damaged.
11/5 -- snuck in a local O race before the "no running" part of the treatment kicks in. OTC orthotics in O shoes. A bit awkward. No pain except on pressure exam. RICE/stretch afterwards.
Stopped going everywhere barefoot. In the long run, I may rather give up running/O than this lifestyle change.
11/7 -- pain in the other foot. Coincident with orthotics? May or may not be PF; no pain in the ligament on pressure exam, but what else could it be?
11/9 - twinges of pain in the morning, but on advice of PT, do stretches before getting out of bed, so this may not be a valid test. PT actually increased pain on the day following, but otherwise no pain.
Plan is to RICE/stretching except for weekend O events until visit with podiatrist. No pain at present.
Feel I could ignore it, but feel the cost of being wrong is too high. Don't know if I'm being a wimp, or appropriately prudent.
08/28/07
Ended up with bi-lateral PF and R patello-femoral pain syndrome (runner's knee) when it was all said and done. All linger slightly, but I am marking it as recovered.
Best things for PF, in my experience --
superfeet orthotics (custom and other OTC did not help)
strassburg sock during acute phase, but leg numbness made this untenable in the long run
active release therapy from a "sports chiropractor" (self-administered after observing technique)
scrunching towels or marbles under toes
stretcing, rolling ice did not help, and perhaps hurt, at least in the case of stretching. Collagen is not very stretchy; in fact, the genesis of the injury may be too much stress/stretch of the collagen.