Each morning for the last 13 weeks I have woken up, unstrapped my plantar boot, while attempting to not awaken Ben with the screeching sound of Velcro coming undone, stretch my toes, pull my heel down from my arch, and swing my legs out of bed, into my Hoka slides and taken my first step. Just getting out of bed has been a whole process for the last 3 months. The crappy days were the ones where I just kept the night boot on and crawled (yes crawled) to the bathroom so as not to put any pressure on my heal without it being warmed up. Big ups to Ben for taking all of the middle of the night wake ups that my kids had because as I alluded to above I couldn’t just pop out of bed and walk into the boys’ room to check on them.
Plantar fasciitis is painful. An injury I wish no one had to experience and one I really struggled to see the finish line. It literally feels like knives in the bottom of your feet every-time you put pressure on it. You want to rub out your arches and heel but at the same time don’t even think about touching my arch.
It’s a condition that doesn’t make a lot of sense but I am going to attempt to make sense out of it for those struggling with it and who have been following my path.
Back in December I raced the marathon project in Phoenix Arizona. Well I tried to race it. My plantar had flared up for the first time in my career about three weeks earlier. I started to notice a slight stiffness and almost sharp nodule in my heel after some runs. I thought just typical wear ands tear from how hard I was training. So I lined up for the 10,000m at the sunset tour on December 5th. We were aiming to run the Olympic standard of 31:25 in the thick of heavy marathon training. With about eight laps to go I felt a change in my stride and an intense sensation in my heel. I grinded the last 2 miles hoping I could hold it together. In typical dramatic fashion (ask Ben, Ben, and Josh) I ran 31:24, just half a second under the Olympic standard. But then I could not walk. I tried to hobble a cool down but knew something was definitely wrong. The next morning I woke up and when I took my first step out of bed it felt a dagger in my foot. I ended up taking the next three days off and do everything possible to keep the momentum going and be ready to race the marathon in 12 days. It improved slightly with rest and every time I had treatment on my lower leg calf and ankle I had a tiny bit of relief in the heel. Ok we’re still on!
So what did I do?
I began with rest because anytime you sustain any type of injury that should be your first course of action. Because I had trained through a marathon cycle, even though I didn’t finish the race, we committed to our typica] 2 weeks off. No running, no cross training, no core work, just OFF. I was still in immense pain after 2 weeks off, so I took another.. and another.. and another. I didn’t run for close to 5 weeks. And guess what it still wasn’t better. I was pissed and confused. The rest principle I prided myself on was not working.
TREATMENT, STRENGTHEN, REHAB
My first run was 2 miles. And it was awful. My heel hurt the entire time. I came home defeated and started doing that thing where you spiral with negative thoughts, projecting in the future, and basically write your own running obituary. Let me share with you a little secret. That never helps. So I told myself to get over it, stop with the pessimism, and start with action. I had chiropractic treatments with Dr. Wes Gregg of Hypo2 in Flagstaff, 3 times a week and John Ball, my chiro in Phoenix. They worked on loosening up my calf, unlocking my ankle, and up the chain to my adductor and hamstring. I was prescribed the following exercises:
Ankle mobs (band around your talus joint, see picture below) and drive the knee forward creating a stretch in the front of your ankle
Peroneal strengthening- using a band to resist you, point your foot down (dorsiflex) and out. You should feel your peroneals ( group of muscles that originate from fibula (lower leg bone) and for this reason, these are also known as fibularis muscles. All these muscles insert into the bones of the mid foot called tarsals and metatarsals, which are present between bones of the ankle and the toes) engage. Perform 2-3 sets of 8.
Post tib eccentric band exercises. Google this!
Glute med holds- lying on your side, raise your top leg and push it behind you until you feel you glute med ( butt muscle) turn on. Hold for 20-30 seconds. Repeat 3-5 times
Calf wall stretches – these were really painful in the beginning and I barely had any range of motion.
Toe presses into the ground with rolled towel- roll up a towel, place under your toes and with your heel on the ground, press your toe knuckles into the ground for 5 seconds and let go. Repeat 6-8 times.
THE Toe Pro: a company started by Tom Michaud, recommended to me by John Ball and a tool I believe will help many suffering from PF. I bought one for $50, use it everyday. There’s a whole routine on their website with videos and articles to assist you. They are the experts not me! And Tom was kind enough to give any of my readers a 20% off code, just use STEPH at checkout.
And the find the cause
Plantar is all about managing stress and load and discovering what went wrong in the first place to get you in this position. For me, I believe the quick transition from flats to spikes for my track 10k did me no favors. But there was also an underlying gait issue that my body was very efficient at going around and compensating for. I wasn’t using my toes as I should, wasn’t pushing off with my big toe, and so my lower leg (calf, peroneal, post tib) got lazy and stopped working for me. Now I don’t expect everyone to dive this deep into their movement patterns and get nerdy scientific but you should feel what may not be working and try to target those weaknesses in your rehab routine.
And give it Time
This is the easiest advice to give and the hardest to take. I don’t mean time as in just time off. That was only 5 weeks for me. But since those 5 weeks, it has been another 7 weeks of patience. After my first run of 2 miles, I took 2 days off, then ran another 2 miles. I tried to run 6 miles a week later and couldn’t. I had many 2 steps forward, 1 step back moments. That seems to be the cycle of PF. But I committed to the rehab, to wearing the night boot, to cold/heat contrast baths after runs, to putting on the blinders of what others were running and comparing. I stopped throwing pity parties for myself and channeled a better attitude. I controlled what I could. My sleep, my nutrition, my rehab, my stress, my mindset.
My plantar isn’t gone. But it’s trending in the right direction. Each week with more volume and intensity it’s less sore. How I felt after a 3 mile run 2 months ago is how I feel now after a 14 mile run. Now’s not the time to get complacent. Now’s the time to double down on all the right things and keep the momentum going. There’s no quick fix. No gimmicks. If you’re finding yourself in the cycle of PF, try some of the above. Rest until it’s tolerable to stress it with rehab, stress it with running very gradually, stress it with strengthening exercises for your calves, your toes, your glutes, wear shoes always until the pain is gone, heat it up when you wake up, take a short walk before you run, and give it time and patience. I got this, you got this, we got this.
originally posted on StephBruce.com