Plantar Fasciitis

I’m not an expert in Plantar Fasciitis (1) but I see it every day.

Yesterday I helped three people with it.  Today in the hour I was assisting on the sales floor there were two.  My step mother in another state even called me tonight asking if I’d talk to her friend about it.

The hardest part about addressing PF is no one knows what’s going to work.  Not your podiatrist, not your physical therapist, not your shoe salesman.

Experts try a lot a different strategies…orthotics, cross training, surgery, cushioned shoes, stability shoes, rockered shoes, night splints, taping, arch compression sleeves, cortisone shots, stretching, strengthening, and so on.

But no matter what we do, Plantar Fasciitis spontaneously resolves the majority of the time all by itself, even if left untreated.

So what do you do if you have it?

Throw everything you can at it and wait it out (2).

 

 

(1) – It’s not technically Plantar Fasciitis for most people.  Fasciitis means the tissues are inflamed.  The body stops the inflammatory process after a couple of weeks.  If your foot hurts in that area for longer than a couple of weeks, and it’s not something else such as a tendon problem or calcaneal stress fracture, it’s almost certainly Plantar Fasciosis, which means the tissue is dying.  That also means anti-inflammatories, which are coming under fire anyway, aren’t going to do much since the tissue isn’t inflamed.  I recommend getting a diagnosis if you suspect PF.  You do not want to break your calcaneus.

(2) – A small percentage of people do struggle with it for years.  I suspect an unaddressed structural or biomechanical issue for most of these folks.

 

 

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3 thoughts on “Plantar Fasciitis

  • February 12, 2016 at 8:30 pm
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    What are your thoughts about barefoot training/running as a potential solution?

    I was diagnosed w/ bilateral PF ~15yrs ago and it resolved w/ cortisone injections and a stretching regimen only to return this fall in my Lt foot as I was preparing for a Spartan race. I’ve done Rehab this go aground with the cortisone injections, but haven’t responded like last time.

    As I’ve started running again, the only time my heel doesn’t hurt is when I run in my Vibram FiveFinger shoes, which essentially forces a barefoot running technique. The more material I read about barefoot running (including Chris McDougall’s “Born to Run”), it seems that a lot of foot ailments and running issues are from poor running technique and poor chow choices.

    I’m interested in your thoughts Eric given your study of running, feet, and shoes.

    • February 13, 2016 at 11:17 pm
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      Hey Adam,

      Thanks for your comment.

      There’s zero research I know of to support barefoot running as a good treatment option for PF. It is of course biologically plausible that running in a Vibram shoe can change loading away from those tissues, but experience and education tell me it’s not very probable.

      Any time you change footwear or running form, you move forces from some tissues to others. Stress is never eliminated.

      Born to Run is one of my favorite running books of all time. Such a great story. Most experts agree Chris McDougall went way too far in his assessment of the benefits of barefoot/minimalist running. Shoe sales confirm it too as one brand of maximalist shoes (Hoka) currently outsells all minimalist brands combined. Last, it was rumored that Chris McDougall got a metatarsal stress fracture from minimalist running in 2010, although I can’t confirm that.

      With that said, your experience appears to suggest a link between running in your Vibrams and improvement in your symptoms (assuming confounding factors that neither you nor I are thinking of could be coming into play).

      When Vibrams were going crazy and we were selling 30 pairs a week to people looking to fix their injuries I was fond of saying, “it’s unlikely this shoe is going to totally fix your pain. Be careful. Start slow and be very gradual. If you get worse, stop wearing them.”

      Most people did not get better but a few did. I’m fond of recalling one of our staff who was diametrically opposed to the concept of minimalist shoes and later found that when her shin splints were at their worst she could only run in Vibrams.

      I’ll also recall and conversation I had with an athletic trainer in our town a few years ago. He said that 80% of the time the patient responded to treatment in the way he expected. The other 20% of the time he was scratching his head. You may be one of those cases.

      So to answer your question, be slow, be gradual, and stop if your feet get worse or new pain arises. The biggest risk from VFF’s appear to be stress fractures.

      Thanks again for the comment.

      Good luck buddy!

  • November 28, 2016 at 1:40 am
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    There’s zero research I know of to support barefoot running as a good treatment option for PF. It is of course biologically plausible that running in a Vibram shoe can change loading away from those tissues, but experience and education tell me it’s not very probable.

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