Plantar Fasciitis and Running

Hi all,

I've been trying to go from walking to running, but I'm curious about some heel pain that I've been having lately. A brief web search makes me wonder if it may be Plantar Fasciitis (the pain is mostly in the mornings, the pain started a few weeks after giving birth to my daughter, and I've been barefoot a lot more lately). It seems to flare up when I'm really tired.

It's not a huge problem most of the time, but I'm wondering if taking up running would help or hurt the situation? The goal of the increased exercise is to improve my health by losing some fat (which, I would think, would take pressure off of the feet). Proper running shoes should support the feet so I'm not creating any "damage" to the heel, right?

I suppose I ought to see a podiatrist, but my schedule is a bit hectic lately (I'm taking a break from cleaning the house at midnight to post this!). I'd appreciate your thoughts!

I tried to write a pretty comprehensive text on this issue a year or two back.

Here's the link.

I'd just add my own (uneducated) experience to Wahine's excellent advice. My heel pain is a little higher up - the kind that masquerades as Achilles tendinitis rather than plantar fasciitis. Mine is all about trigger points in the calves. No amount of stretching or good form will make them go away. I have to work on them directly, and it's tough because they're SO deep and ingrained. But I hold out hope that one day I'll have them all worked out...

There are those funny looking plantar fasciitis socks you can get to sleep in. I've seen them at running stores.

I have also been told that running barefoot or with Vibram five fingers really helps

Please discount my reply because I work for a chiropractor.

We successfully treat lots of folks with PF. There are several therapies that are useful....I'm sure Wahine can explain them better than me....I just work the front desk. there's ART (Active Release Therapy) (the DC that I work for is not a "licensed" ART (little trademark thingie) therapist. But he does a manual therapy that is essentually the same. its a deep tissue massage while moving the muscle/tendon/fascia through it's range of motion (kindergarten explanation). also, muscle stimulation combined with ultrasound is very helpful.

the thing with PF is to not let it go on.....get treatment early. it can be a bear to get over and seems the longer it goes on, the longer it takes to get better. the way it was explained to me is that it would probably get better on it's own, if you gave it complete rest until it was healed, but that could take months.

Not really an answer to your question (but I'll say that when I had PF, my podiatrist didn't believe that I should stop running).

My recommendations: Solidly increase your intake of omega-3 fatty acids, whether through whole food or supplements. (They help reduce inflammation.) Deep massage is also good, but the golf-ball trick didn't work for me. Instead, what seemed to work is sitting in the hot tub and sticking the bottoms of my feet right against the spray jets.

DO make sure you get good running shoes, but DON'T spend money on custom orthopedic inserts. My podiatrist actually didn't recommend them, and in retrospect I think he tried to subtly steer me away from them, but he was willing to order them for me. They did nothing for me and I've heard from a number of sources that they're no better than the ones you can get from the foot care section of your pharmacy.

We just had a podiatrist speak at one of our Team in Training practice walks. He told us about a new treatment for Plantar Fasciitis. From his website:

"Shock Wave (ESWT) and EPAT Treatments: Extracorporeal Pulse Activation Treatment or EPAT uses pressure waves to stimulate the metabolism, enhance blood circulation and accelerate the healing process. Tissue gradually regenerates and eventually heals. This non-invasive treatment can be used for acute or chronic plantar fascitis, achilles tendonitit, shin splints and other tendon/muscle pains."

I had warm water therapy, with some type of stimulation, which shot little pulses into the appropriate areas of my foot when I had PF. This was probably almost 25 years ago and it worked like a charm. I went to a podiatrist for treatment.
I *did* get the custom orthotics for my aerobics shoes, but my insurance paid fully for them and they also were to keep the stress fractures at bay, since i was teaching classes on horrible floors.

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Originally Posted by Reesha

There are those funny looking plantar fasciitis socks you can get to sleep in. I've seen them at running stores.

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It's called the Strassberg sock. I've used it and it does work, along with exercise and stretching. Just drives me nuts having my foot dosrsiflexed all night. And I hate having stuff on my feet at night. But ya' gotta' do what you gotta' do.

Snap, my husband's clinic has been doing the shockwave thing. It does work. But it also sounds very painful...

Actually, I had the shock wave treatment done and it didn't hurt, AND as long as I don't spend much time going barefoot, it's pretty much gone. And I am running regularly.

Just chiming in with another personal experience: I had PF way back in college when I was running a lot and treated it with stretching and rolling my foot over a tennis ball. I was probably also taking ibuprofen for my knees. I have flat feet, so I tend to develop problems associated with bad foot mechanics. The PF pain was probably an issue for me for 1-2 years, and then I think with better conditioning and keeping in the habit of stretching on a daily basis it stopped bothering me.

Many years later I got custom orthotics which were partially paid for by insurance. I've had them for 8 years and while I don't run as much as I used to, there is definitely a difference in how I feel after a run or a hike if I have my orthotics vs. just the insole that came with my shoes.

Thanks everyone for your replies!

I'm not sure that it actually is Plantar Fasciitis (just my best guess based on some basic web searching), but it looks like stretching/strengthening/massage the feet and lower legs couldn't hurt. :)

Has anyone tried the Vibram Five Fingers? I'm still not able to make an "educated" decision on these (or the whole barefoot thing). My husband's orthopedist told him that due to the fact that he has almost no arches, he should pretty much wear shoes (with inserts) all the time. I also have fairly flat feet, so I suppose that would apply to me as well. However, from what I've read about the Five Fingers and/or Running barefoot, that's actually supposed to be better for you, once you've accustomed yourself to using the different muscles. Where do you stand on this? Are shoes or no shoes better? Or is this a "it depends" kind of thing?

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Originally Posted by nj_likes

Has anyone tried the Vibram Five Fingers? I'm still not able to make an "educated" decision on these (or the whole barefoot thing). My husband's orthopedist told him that due to the fact that he has almost no arches, he should pretty much wear shoes (with inserts) all the time. I also have fairly flat feet, so I suppose that would apply to me as well. However, from what I've read about the Five Fingers and/or Running barefoot, that's actually supposed to be better for you, once you've accustomed yourself to using the different muscles. Where do you stand on this? Are shoes or no shoes better? Or is this a "it depends" kind of thing?

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I have the VFFs and run/hike in them, and think they're great! I do subscribe to the theory that barefoot/minimal shoes are better--it just doesn't make sense to think, as the shoe companies seem to, that our feet are so poorly designed as to need all that padding and built-up heel that most running and other shoes have. As far as I know, hrough most of history, footwear (if any) was pretty simple and served only to protect the feet from extreme temperatures or hazardous objects on the ground: people in biblical times wore sandals (and I'm sure these sandals didn't have the "support" of some modern ones), Native Americans wore moccasins or went barefoot. It seems more logical that the human foot (as well as the rest of the body) is designed to function best without shoes that interfere with its natural movement. That said, most of us now (in this part of the world) are used to wearing such shoes all the time and need to take it slow in changing to barefoot/wearing minimal shoes--if you try to go "cold turkey" you might hurt yourself.

Our feet are nice flexible irregular blobby things that do a wonderful job on nice flexible irregular surfaces. (dirt)

So many foot problems come up because we live in a flat hard world. (pavement and floors) Every step our feet take in this homogenous hard flat world makes them move in one way, over and over again. It's a repetitive stress injury just waiting to happen. Some foot muscles get lazy because they are hardly ever asked to work. Some foot muscles swoon because they are forced to work every time and never get to pass the buck.

The plantar fascia ends up taking far more stress than it was meant to. It is your foot's last resort. (the muscles are the foot's first resort) All this stress that was never meant to be there starts causing microtears in the plantar fascia and pulling tissue away from the bone, which leads to heel spurs as the body fills in the gap with more bone.

You can think of modern shoes as an attempt to get a little "dirt" between our feet and the flat world we've created. Highly technical and over-engineered portable dirt, but really just dirt! Hard and flat on the sole side to match the hard and flat world. Irregular and flexible and smushy on the insole side to match the irregular flexible blobby foot.

Toe exercises and barefoot walking on Cobblestone Walkways (either real or fake) are quick ways to perk up the muscles that the foot should be using all along. http://www.fitter1.com/Catalog/Items/CBLSTN.aspx

I like VFF, but I can't wear them. Our toes want to work! Injini socks are great for freeing your toes inside shoes and they let you wear flip-flops or Chacos in colder weather. http://www.injinji.com/

Knot, good point about the hard flat surfaces being part of the issue as well--we spend more time on these than is natural and healthy, and it does result in neglecting a lot of the stabilizing muscles. As far as modern shoes, why do they (almost) all have an elevated heel? That changes the whole weight distribution of the body and interferes with walking mechanics causing the heel to hit the ground harder and earlier than it otherwise would. A lot of shoes also don't give the toes enough room to spread out and work the way they are supposed to.

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Originally Posted by Jolt

As far as modern shoes, why do they (almost) all have an elevated heel? That changes the whole weight distribution of the body and interferes with walking mechanics causing the heel to hit the ground harder and earlier than it otherwise would. A lot of shoes also don't give the toes enough room to spread out and work the way they are supposed to.

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Part of it must be fashion. Part of it (like in running shoes) is probably intended for shock absorption. Part of it (like in hiking shoes) is a need for a heel that can help with grip and balance like our own heel would if we were barefoot.

I cannot run well in running shoes. I wear Chacos to run in, and have much happier feet, knees, and hips now. Looking at the pair I'm wearing right now, there isn't much difference in sole depth between the heel and the ball of the foot. http://www.chacousa.com/US/en-US/Pro.../Black/J100024 (the lateral counters create an optical illusion that the heel is thicker, but it actually isn't)

ETA: I just got out a tape measure: the sole at the heel is 1.5cm thick, and at the ball of the foot it is 1.75 cm thick, tapering out to 0.6 cm at the tip. (these measurements don't include the replaceable outsole/traction layer, so there is no distortion from wear) Looks like Chacos are built a little bit like Earth shoes, with the heel lower than the ball of the foot.