plantar fasciitis?

Need some help here. It seems that i may be developing a case of plantar fasciitis. I started to feel a little pain in my heel a few days ago. I immediately iced and immobilized it that night. I tried to stay off it since then and have been icing it pretty much. It doesn’t seem too bad now. Not really any pain, but the arch still feels a little tight. Just doesn’t feel quite right. Any ideas on where to go from here? The last thing i want is to be screwed the next few month with planter fasciitis.

No doubt, the first thing you should do is get appropriate insoles if you don’t use any already. 90% of the time this is solved by correcting a bad habit with how you step or in the cushioning of your shoe. Also look for exercises you can do to help. I’ve seen a few of the athletes in my previous training group go through this last year. They used some exercises with tennis balls, etc along with laser or whatever treatments methods your doctor recommends.

forgot to mention that i have a slight tibial torsion on my right side, the same side as the fasciitis. Pretty much all of my lower body injuries have been on this side. Slight patellar chondromalacia(feels fine now) and some inflammation in my right hip which was most painful at the parallel position in my squats. The arch is the problem now. Guess a podiatrist may be the way to go, huh? any suggestions?

Sounds like you have a flexibility or strength problem to compound this. There is no reason why a properly fit athlete should ever have CMP (chondromalacia patellae). Did you start training all of a sudden recently after a long layoff or something? It’s typical of trying to start off with too much too soon. Sprinting, bounding, stairs, running on hard surfaces, etc. without having proper flexibility and or strength will result in CMP because there is too much tension/friction in the knee joint. The right hip, if it’s in the front of the hip you’re probably facing an iliopsoas flexibility issue, seems to be another classic. Get yourself a proper stretching routine as first measure or you’ll go from problem to problem. Regardless of whether you have flexibility or strength issues, seems like going to a podriatist is essential if you have a problem as you say on your right side. Hope this helps. I’ve been through similar problems years ago when I was restarting track, I went through virtually every minor/nagging injury in the book. CMP, runners knee, jumpers knee, tronchanteritis, plantar fasciitis, shin splints, constant quad and hamstring strains, calf strains, bursitis, iliopsoas pain, etc. I know what a pain in the a-- it is to go through all those setbacks when you’re trying to begin training seriously. It can be hell. Neverending hell. Until you solve, in particular, flexibility issues.

Actually, my flexibility is pretty good. I’m not a gymnast or anything, but i’m pretty flexible. Don’t really think strength was the issue either. Lower body is strong and the strength ratios are pretty well balanced. The orthopedic i saw said i have a tracking problem in the right knee. From there, i did some extra VMO work and haven’t had much of a problem in the knee since. The hip pain was not in the front, it was pretty deep in the joint. I have no clue where that came from. I have pretty good hip mobility. Yeah, these problems are a real pain in the ass and i would like to get rid of them so i can get back to training hard. I especially can’t afford to develop planter fasciitis. Thanks

I had good luck with stretching the entire posterior chain. It seemed that hamstring and glute tightness had more to do with my plantar fascitis than anything else.

Ahh I’ve had this crap now for almost a year and it’s been the most annoying thing I could imagine. It started out last winter when there was like 8 inches of snow on the ground, for 2 weeks, and I decided to run on the street. Combine that with a pair of shoes with an arch cut too high and I quickly started developing the symptoms. It passed from one heel to the other and for the last 7 months has affected my right heel and I haven’t been able to do much of anything without pain. I tried ice, complete rest (made it worse), and orthotics.

Anyway, I think I finally found an approach that works. Some type of arch support is very important with custom made orthotics probably your best bet. Next, at least in my case, frequent vigorous self massage in order to break up any rough tissue in there seems to work wonders. Also I stick my foot in a bucket of ice for 10 minutes followed by hot water once per day.

Hope this helps.

At the onset of any plantar fascia pain, it’s extremely important to stay right off the bad foot. Use crutches if necessary. Don’t put any weight on it until the pain has completely gone. When you begin running again, if you feel any pain, you must stop and rest until the pain goes away. Nobody can ‘run through’ plantar fascia pain. If you do, it can develop into a chronic problem. Icing it may be a bad thing, since there is mounting research suggesting that icing slows down the healing process. If you still have pain after resting it completely for a couple of weeks, you may benefit from Prolotherapy. This treatment is usually very successful in treating cases of plantar fasciitis, but you must consult with an experienced Prolotherapist.

Justin, if you’re reading this, how is your plantar fasciitis now?

I just came across this site on plantar fasciitis: and this page (same site) on using prolotherapy to potentially cure this condition (as well as other ailments): - (If Charlie or anyone can give high recommendation for a treatment centre in Toronto where one can get this done, I’d be eternally in their debt!)

Just dont get a cortisone injection into the site whatever you do. I had plantar pain when i was sprinting in High School and i went and saw a GP who administered a local cortisone injection. The pain was gone.A couple of days later during a race I sustained a Lis Franc fracture(look it up, its BAD) which was attributed to the treatment. Tens years later my foot is still stuffed.

I would very much like to read some of that research, can you post the source? thanks

First, before starting any sort of treatment, aside from icing and rest, tell us the mechanism (how it happend? where? with whom? alone?) of the injury. Only then, can you make an accurate (well, close to anyway) disgnosis and treatment plan on how to tackle any injury; otherwise, you are making assssumptions based on standard protocol, which isn’t necessarily a bad thing, I just assume that you want to be as accurate as possible.

Also, I agree with some of the things Aln was mentioning in his earlier posts regarding footware. I just wanted to ask, what kind of shoes are you wearing? are they proper for the type of exercise you are doing? (this is also dependant on the mechanism of injury). How old are they? these are important questions.

Lastly, you said “The orthopedic i saw said i have a tracking problem in the right knee” can you clarify what the Dr means by Tracking?

Well, can really pinpoint a specific instance it first occurred. A while back my foot started to feel tight in the arch. I stretched when i felt tightness and it went away. A few days after that i felt a sudden pain in my heel going into my arch whil walking. Stayed off it from there and rested and iced the weekend. At the time i was just lifting, no speed or plyo work. It’s been somewhat ok since then. I’ve seen an ortho and he said it may be the beginning of fascitis but he felt i caught it pretty early and stopped oit from getting worse. He did an analysis and i have some slight external rotation going on with my right foot which causes me to slightly walk ant run on the outer edge of my foot. I have since gotten orthotics and i am adjusting to them now. I started conditioning again 2 weeks ago and so far i’ve been ok. I still get an ache in my arch sometimes after sprints. I try to ice when i can to keep it from flaring up.
As far as the tracking problem…what i was told is that my patella tracks laterally a bit to much which was causing some excessive wear and inflammation in my knee. Its been ok for several months now, but it is in my right knee, which is the same side as the heel pain. Hope that answers you questions.

Asbury Park, from NJ I’m assuming. Get the orthotics and have the hip
x-rayed because the problems you are experiencing may have begun from the foot up or the hip down. Never is it one source or misalignment that creates pain or injury. I’m not in favor of the shotgun approach to treating injuries. Meaning don’t try EMS, US, massage, ART, etc… all at the same time because how will you know which is working. If you have access to different treatments pick one try it for a week or two if it works stick with it. If it doesn’t work try something else.

The things that have worked the best with plantar fascia pain are:

  1. Stretch the calf before getting out of bed in the morning. Or better yet wear night splints.

  2. Put shoes on before first step in the morning.

  3. Deep cross friction massage

  4. Adjustment to the foot and ankle.

As well as getting the hip and knee evaluated. Hope this helps.

check and check. i’ve got the othotics and have had the hip x-rayed. Orthotic seem to be helping. I’m back to training again (tempos, sprints, plyos, etc) but not yet at a high volume. As for the hip, the x-ray was fine. Showed not problems, but i’m always skeptical about x-rays for these types of probs. You see little as far as soft tissue trauma. Dr. said my rotators in my hips were a bit tight and told me to stretch the out. I have been and the pain has been slowly decreasing. I’m just back to squatting to full depth. Still have some pain, but is getting better. In a few weeks i will be at a high level facility for the rest of the summer, so i will have more in the way of treatment and attention from therapists and trainers. So, that should be a big help. It’s will be nice to be around people who really know what they are doing as far as athlete rehab goes. Oh, yeah…Asbury Park, NJ is right, but i’m not from there.

Asbury Park, the reason I like the hip x-rayed is there may be boney pathology that could create problems down the chain to the foot. Muscle length and tension around the hip is very important.

Make sure you wear the orthotics when you squat. Here is an interesting “magic trick” to prove the value of orthotics. With bare feet, bend over and touch your toes, see how far down you go. Now, stand on your orthotics, bend over and see how far you go. Should be further! It works with most everyone. Give it a try.

Submitted for your mulling and general consideration/discussion - Shockwave Therapy info - (especially of interest to folks who live in Toronto, or are willing to come here for treatment):