22 November 2011

Pain of not running and plantar fasciitis

How much pain would it cause you not being able to run for a year or more?

From A.D.A.M. Medical Encyclopedia (1).
A friend of mine, an avid runner, sadly developed plantar fasciitis (PF) on both feet. Unfortunately he ignored early pain and symptoms and continued running. He has been off running for more than a year by now.

The location of the plantar fascia on the underside of the foot makes PF one of the nastiest injuries to treat and get rid off. With every step you do, running or in daily life, you literally step on it and keep on injuring the plantar fascia. Believe me, plantar fasciitis is to be avoided at all cost.

A.D.A.M. Medical Encyclopedia (1):
Plantar fasciitis is inflammation of the thick tissue on the bottom of the foot. This tissue is called the plantar fascia. It connects the heel bone to the toes and creates the arch of the foot.
The most common complaint is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn.
The pain may develop slowly over time, or suddenly after intense activity.
Recognizing any of this or if your first step out of bed in the morning hurts on your heel or arch, don't even think about running. Go see a doctor (preferably sports specialist) or your physiotherapist as soon as possible.

Tucker and Dugas in Runner's Body (2):
If you catch the problem early enough, you may be able to overcome it with a moderate reduction in running mileage. However, if it becomes severe, you may have to stop running altogether for a few weeks. Let pain be your guide - never run beyond the point of moderate discomfort. Cross-train in modalities that you can do pain-free to maintain fitness and reduce the temptation to resume normal running training too quickly.
In case you are unfortunately diagnosed with PF, ask what to do about it. Depending on the severity of the case, there are a variety of more or less aggressive therapies available.

Tucker and Dugas again (2):
The more aggressive treatments for plantar fasciitis - namely cortisone injections and shock wave therapy - work best, but most physicians are reluctant to prescribe them for those who have had the injury for less than six months. If you can't shake your heel pain in a few weeks, push for the more aggressive treatments, which elite runners routinely get early.
Try to find out what might have caused PF in your case. Valuable information for your future training regimen.

If you don't suffer from PF, one way helping to prevent it (or any other injury) may be by an assessment of your running relevant biomechanics.

Barbara Denson, a Bangkok-based sports physio, calls PF a "very problematic injury" and says (3):
However, one of the most important pieces is checking biomechanics of the pelvis, leg and foot. Working out what's not in balance. What requires realigning, loosening and stabilizing. In my clinical experience it's important the foot and lower leg is assessed as usually there are long term issues which end up relaying to the PF.
Overuse may also be a contributor to developing PF. Doing to much to soon, a sudden and significant increase in volume or intensity, insufficient rest between sessions, repetitive stress of the same type are the underlying cause of most running injuries. Your body's systems aren’t able to cope with the load you impose on them. Improper or worn-out footwear can also play a role. Make sure you have a training plan that balances training stress and rest and gradually increases load.

Fortunately in a way, not all pain on the underside of the foot is caused by plantar fasciitis. One more reason to go see a qualified health care provider quickly. After all, you want to run. If the diagnosis says, no PF, you can breath a sigh of relief.

The Take Away Message here is: if you experience any of the above described symptoms or suspect PF for any reason, don't take it lightly! Go get diagnosed by a qualified health care provider right away. Plantar fasciitis is to be avoided at all cost!

In need of a qualified health care provider in Bangkok (Thailand)? Send me a message via Contact (above).

(1) PubMed Health A.D.A.M. Medical Encyclopedia. Plantar fasciitis. Last reviewed: February 19, 2011. 
(2) Ross Tucker, Jonathan Dugas, Matt Fitzgerald. Runner's World the Runner's Body: How the Latest Exercise Science Can Help You Run Stronger, Longer, and Faster. Rodale Books, 2009, chap. 3.
(3) Plantar Fasciitis. Discussion via TriNerds. E-mail (2011-12-06 08:03) by Barbara Denson, Sports Physio, Bangkok, Thailand.

1 comment:

  1. If the pain persists see your doctor. If you do not see a physical therapist then it is something to consider. They can help you learn exercises that will reduce the risk of arthritis or soft tissue damage in the future.