Coming back from plantar faciitis??

Not a doctor but I've had this injury twice in both feet. Nasty stuff.

First off - if you want to try to maintain some running fitness while you are injured  pool running or deep water jogging is great. Here is a helpful article if you are interested in reading more about it:

http://www.pfitzinger.com/labreports/water.shtml

I'm not sure what you're doctor has recommended for recovery but I have had a lot of relief from ART (active release therapy) this year for different issues (feet and knees). You might ask your doctor if that is an option for your PF.

As far as getting back into running - yes you will have to take it slow. I would start with a combo of run/walk and progress from there. Of course you'll just want to pay close attention to any kind of discomfort in your foot. It's been several years since my PF so I can't really remember my method of getting back to running. I was laid up for 9 months though so all run fitness had disappeared. Just listen to your foot. It will tell you when it's angry and I'm sure you've realized you don't want to go there!

Good luck!

What kind of Physical therapy are you currently doing for it?  Are you walking around flat footed on flat surfaces?  If you are...pretty much stop doing that right now.  You should be wearing supportive shoes ALL THE TIME.  I can't stress that enough.

What is the severity of your pain on a scale of 1-10?  How often do you have the pain 100% being that it hurts every moment of every day?  What time of day?  Does it hurt more when doing certain things?

Once you start again you're going to have to do some serious stretching out of your calves and feet.  I roll my feet on a baseball after I stretch, every night.  Also ice both feet right after your run/walk.  This is really important to tackle the inflammation.  Do it even if it doesn't hurt.  I've had mine since August of last year and it's taming down now after a lot of physical therapy and three cortisone shots in my left foot.  It's not easy, so be patient with your feet...you're on them every day.  There's not real rest for your feet.

Start with a run/walk routine.  If you're really interested in doing this and will dedicate yourself to doing the run/walk, I can send you the program that I did to get running again.

It's so important that you at least do the icing and stretching.   Not doing these two things is like praying for a flare-up.  Do not get lazy on this.

I've had PF in both feet on-and-off for 2 years. Once you tear or damage the plantar facia it seems to be very suceptible to re-injury. It's not a fun journey to recovery. 

Some things that helped me:

1. Strassburg sock (or similar device) - it streches the foot at night so that the faciia heals. Streching, particularly post run, seems to be my friend. 

2. Massage the sole of the foot by stepping gently on a golf ball - stimulates a bit more blood flow to the region and help speed up the healing and maybe breaks up the scar tissue?

3. pain releaving spray - those muscle & arthritis releaf rub on / sprays with Salicate, Menthol, etc. help a bit.

4. Orthodics. I have had some success with pharmacy off-the-shelf arch-support orthodics for sports shoes - if you have extreemly high arches like I do this may be a way to go.  I had a custom set of orthodics but those did not do much for me (I think the doc may have screwed them up - the fitting took 3 minutes).

Best of luck and wishing you a speedy recovery.

double post - sorry

As the other posters said, there are many differing opinions on the causes and treatments of PF.

I tend to agree with Maura9900 and disagree with the guy that said never walk around flat-footed or without supportive shoes although I know this is the conventional wisdom on the issue. I had to do a lot of PT to strengthen my feet also because I had no range of movement.

I got PF in the fall of 2008 and although I can run now, it is something that I think about and work around on a daily basis.  My PF gets worse when I wear heels or any other shoes that allow my toes to point.  I attribute this to a lack of flexibility in my legs.  I am most comfortable barefoot or in Vibrams for walking around, though I do not run this way.  In the interest of full disclosure, I run in Brooks Glycerins and recently got some Green Silences for shorter runs. 

If my PF is talking to me at all or if I have any pain, at night I wear a boot (the Futuro brace that you can buy at your grocery store) on my "bad" foot and a homemade version of the Strassburg sock on my "good" foot to keep my feet from pointing while I am asleep.  I stretch my legs (calves, back, glutes, pinformis, hamstrings) every night without fail whether PF is looming or not and massage the bottoms of my feet and my ankles every day.  If I skip more than one day a week on the stretching, the PF flares up.

I find that tightness in my calves (from longer mileage or speed or from standing or sitting for long periods) irritates my PF so I have to be very careful about that and do extra stretching or take a day off if necessary.   In extreme cases, I'll take some ibuprophen.

On the recovery, I was able to build back my mileage slowly using first walking and then a run/walk and have finished both a marathon and an IM after my injury.  The key is to be sensitive to your PF and know when your calves need stretching or babying or when you need to suck-it-up and take some NSAIDs.  FWIW, I took 4 months off of running and saw zero improvement in my PF but when I started walking again, it slowly got better.

Best of luck on your recovery.  Please feel free to PM me if you want to discuss.

For you two that had no luck with supportive shoes, do you have low or high arches???  Just curious as to if that has something to do with it.  Did wearing a supportive shoe actually hurt your foot?

This is very interesting to me.  I completely agree with the strengthening of the foot thing, but have never heard that walking around barefoot actually helped.  Typically PF occurs from a lack of strength in one way or another.  I found that I could mitigate the issue by properly supporting the foot and allowing me to work on my imbalances.

Also agree that everyone is different...you'll have to listen to your body.  It's one of those things where you should only do what makes your feet happy.  The more inflamed you let it become, the worse it will hurt and the slower it will heal (no pun intended).

Thanks, everyone. To answer some of the questions:

1. Pain varies, but is nowhere near where it was the day this first appeared (2/21/11). That day was a 10. Comparably, this AM is a 2-3. Sometimes its a 0, but it never goes past a "5" compared ot the initial injury pain. Foot does not necessarily hurt more in AM than any other time of day.

2. Doc prescribed 2 weeks of ibuprophen (600mg) 3x/day, gel inserts for all shoes (just flat regular gels, not arch support, etc), and rest. In addition, I have a frozen water bottle I roll my foot on 3x/day while at work, stretch dailiy, and do foot strenthening exercises such as using my toes to write the alphabet.

3. as for shoes, I wear leather loafers during the day at work, other times is either my sneakers or casual LL bean slip on mocs. Doesn't seem to make a difference in weather my foot hurts or not.

I have to say I'm a bit freaked out that this crap could derail my whole year. I'm already puling a DNS for my planned half mary, and potentially a 10k in early april. I'm going to take it slow whatever it is to get this cleared up, and get back on the road.

This is actually pretty good news.  If it's only been a few weeks and you're already down to pain level 2-3, you're doing really well.  That doesn't mean go out and run 5 miles today.

I'm not a doctor or anything, but I would do some research on a good Podiatrist in your area and get a second opinion on those inserts.  I would do some self massage on the tight areas as well.  You have to loosen up all the crud that is damaged in your foot.  It's not pleasant, but works great for me.

And running definitely makes your feet hurt worse?  Does it hurt while running or just after?

I haven't tried to run since this happened, so if/how much it may hurt I don't know. I plan on giving it the 2 weeks the doc ordered, so I'll wait.

Current shoes are Saucony Triumph 8. They are comfy, and have had them for 2 months before this injury happened. Don't think they're a culprit - had zero problems before the PF appeared.

The doc was a orthopedic foot guy, and was pretty definite about the gel inserts. I even asked about them needing to be arch support, heel, etc, and he said no, just regular get inserts.

I have a baseball I roll my foot on during the day in addition to the frozen water bottle.

The pain had subsided quite a bit since this happened and has leveled off to a semi constant irritation. Hurts most when I do something involving being up on my toes like climbing stairs.

I got into Tris b/c I had such a bad case of PF I couldn't run.  Tried to run through it (after many years of running, I had never heard of it and didn't know what it was at the time), big mistake, lol.  When the Dr told me what he thought it was I didn;t believe it, it felt like I had a rock or something in there somewhere.  I started swimming again b/c I travel alot for work and have always worked out when on the road.  That was probably 5 years ago.

I believe my PF was caused (or at least brought on by) from wearing a pair of flip flops with no support at all.  The reason I think they were the cause is b/c after I finally got it to 'go away' after many months with no running (I personally feel I will always be susceptible to it again so I am very careful, I occasionally feel it and stretch a lot when I do) it would flare up after wearing the same flip flops.

Just wanted to throw this out there in case you wear shoes like this - I wouldn't recommend it.

I've got one of the boots that pulls your toes upward (like the Strausburg sock does) and I also have a Dr. Shoals insert for PF in every pair of shoes I own.  I had more expensive inserts but they seemed too hard and the other Dr Shoals seemed to keep things at bay.  I also do a lot of calf stretching (which can stretch the bottome of your foot) and some yoga stretches - don't know what they're called but one is doing deep knee bends/squats with your butt as close to the floor as possible which puts you on the tips of your toes and gives you a good stretch in the calf and bottom of your foot. 

Good luck in your recovery, PF can really, really hurt.  I liken it to a Kidney stone.

CJ

First, I am no doctor so take my advice as just that.

But no, I don't think that supportive shoes "hurt" my feet at all.  I wore hiking shoes every day when my feet were at their worst.  The hiking shoes allowed my foot to rest when it was very painful (initial onset of my injury) but they just did not aid my recovery.  I think that sometimes doctors tell patients to wear shoes with a heel or to put a heel pad in their shoes to alleviate the initial pain, but IMHO, that is not a long-term solution.  I have two aunts who were told to "always wear a low heel and supportive shoe" when they developed PF after I did and their pain did not ease until they started stretching and rolling on a ball like I did.

I think (and again, I'm no doctor) that my lack of leg flexibility caused a stress on my plantar fascia that I experienced before my PF as "sore feet" after runs and bikes.  This is hindsight, but I believe that I just ignored the pain in my feet as something that happens when you run longer because I was building mileage for a marathon while I trained for my first HIM.  

Post-diagnosis, I am much more likely to pay attention to aches and pains in my feet/legs and I think that has helped me "tone it down" when I'm on the cusp of an injury.  So anyway, to your point, now when my feet hurt I am more likely to go barefoot or in my Vibrams than in a supportive shoe and that helps my pain ease by stretching out my calves in an easy way as I go about my day, which sounds weird but that is what works for me.  However, please don't take this as me saying that shoes caused my injury because I think it was just my lack of flexibility and not listening to my feet as I built load on my body. 

Yeah...see, that's exactly what I did as well.  Went to the "best known foot orthopedic guy in the area".  He basically did exactly what your guy did and sent me looking for a generic insert that did virtually nothing for me.  Honestly, I wouldn't be running at all right now if it weren't for the inserts.  They allow my feet to rest in between strengthening exercises and stretching.  If you still have trouble after a couple weeks I would strongly suggest that second opinion, from a person that only deals with feet, period.

Good luck though...feet are a pain in the, well, foot I guess.

Understand exactly what you mean.  And I think in a lot of ways you are correct.  These things always happen from underlying issue.  For me, my flat feet put a ton of stress on the medial PF tissue and when I am barefoot, it only exacerbates this problem.  Do you have really flat feet?

Sorry to hear about your PF.  I've recently (Jan-2011) came down with a case of PF in my left foot as well.  I was running about 20 MPW as well and it came on all of a sudden.  I switched running shoes and was running outside in the cold.  I too am a larger athelete who hovers around the 200lb mark.  Fast forward to today.  PF is GONE. 

I didn't take any time off running.  A few things to consider.

1. How many days a week are you running?  I was doing 3-4 runs a week and it simply does not work for me.  I've since moved to 6 runs a week.  3 recovery type runs, 2 moderate runs and 1 long run..  I'm using the 1:2:3 formula for length/miles of my runs.  I've never felt better in all the years I've been running and doing triathlon.

2.  www.tptherapy.com  I've been a strong believer in this product for a long time now.  The full hip dysfunction kit is a god send.

3. Strausburg sock worked a little for me but really didn't help with my toes.  Put to much pressure on my toes and ankles.  Even when it was loose as the strap would allow.

4.  Find someone who does Graston.  After only 3 treatments of this, I was almost 100% pain free.  Three months later, I still got to my guy and he said almost all of the scar tissue on the PF is gone. 

5. Don't stop running.  Drop your intensity out.  Get new shoes if need be.  Move indoors onto a treadmill.  Stretch before and after your run.  Core strength. 

6.  Evaluate your work shoes.  Mine seems to be contributing to the PF pain as well. 

7.  Stretch your calf's a lot!


Good luck. 

Your onset seems to mirror mine exactly. Was doing 3 runs a week. 2 around 6 miles and a long around 10 at the peak before injury. What is Graston?

I'm not so sure i could run worth a crap at the moment. While my foot pain isn't awful, I'm not so sure my foot wants to start moving again just yet. I'll definitely take a look at the things you point out in your post. Thanks!

Don't freak.  I had a bad case and running fine with no issues.  I did switch shoes; started with Asics and now using Brooks.  Are you sleeping with a boot at night to keep your foot straight during the rehab?