Plantar Fasciiitis

[Ed]

I've had pain on the bottom of my left heel for some time, which of course I've ignored, and which of course has become worse. Yesterday a hike from Humber Park to the summit turned into a slow, painful ordeal on the way down, so I looked it up on the web. It is surely plantar fasciitis, the symptoms match perfectly. The recommended treatments are rest, ice and stretching exercises. The problem of course with rest is that you lose fitness. It seems to be a very common condition. If any of you have had experience with it, I am all ears.

[63ChevyII]

I'm here to listen too. First real experience with it was on Day 2 of my HST hike.

[Hikin_Jim]

Ed,

I suffered from PF for a lot of years. Occasionally it flares up now, but it's pretty under control.

Some observations on my part:
1. It's really common. Once I started talking about it, I found tons of hikers, runners, etc. who also had it.
2. Ice? Pfft. Didn't help me a bit.
3. Rest? Maybe of some benefit, but only if you catch it early, and I mean early. Once it gets bad, nope.
4. Stretching? Ding-ding-ding, we've got a winner here. More on that in a minute (see below)
5. Ibuprofen. It won't solve the problem but it does give say a 5 or 10% effectiveness boost to stretching.
6. Shoe inserts. I got custom orthotics at first. I'm now using green Superfeet, but I got the PF under control first.

Stretching:
1. Before I get out of bed, I lie on my back, point my legs at the ceiling and grab (gently) my toes, pulling my toes toward me. If you can't reach your toes, loop a towel over the balls of your feet. Get it to the point where you feel the stretch and then hold for 60 seconds. Over time, you should be able to grab the balls of your feet. I'm fat and in my 50's and I can now do toe touches just fine.
2. The Step Stretch. No, I don't sell them. But it worked for me. YMMV. No, just stepping on a raised surface like a stair didn't do it as well as a Step Stretch, at least for me.

3. Any time, and I mean any, that I felt pain in my heel area, I would stop, put my heel on the ground and the ball of my foot on top of a rock, log, or whatever, something 3 or so inches high, and stretch for 30 to 60 seconds. That helped a lot. Once it gets inflamed, it's really hard to get it to go away.

I tried some other things like:
1. Devices that hold your foot in a certain position while you sleep: FAIL. Worthless.
2. Heel pads that provide cushioning: FAIL. Worthless. It's not an impact issue, it's a tightness issue. Stretching cures.

Were I you, I would definitely avoid steroid injections or surgery (if it's really getting bad, those may be recommended to you).

HJ

[guest]

Hi Ed,

Jim makes some good points, especially the stretching, and, as he mentioned, hold the stretch, not just a few seconds.
You will actually feel some release, if your observant.

Another thing I highly recommend is walking barefoot, on the ground, as much as possible.
This not only stretches the feet, but allows them to be feet again, and moving over uneven surfaces helps.
Plus, and this is big, your earthing, or grounding your entire body by doing this.
You can go to earthing.com to check it out.
I've been grounding myself for several years now, and absolutely notice short & long term benefits.
When I finish Skyline, as have a nice place away from anybody, (since I don't use the concrete walkway), and take off my shoes & socks, ground for about 20 min. while I eat good, needed food, (of course one could always just make a bee-line for the bar instead). My feet & whole body feel better, and the following day I'm not nearly as fatigued & sore, (plus I sleep grounded too). After my San Jac hikes, I go to my fav coffee shop & sip a cold one with my bare feet on the cool grass.

Tour de France cyclists have been grounding for years, nfl players like Arron Rogers, top triathletes like Chris Lieto, (no, their not paid), & many other folks are discovering the benefits. And it's free, & one can do it anywhere.

Happy hiking,
ss

[Ed]

Jim,

Thanks very, very much for your comments. Exactly what I was looking for, and consistent with my intuition and experience with other problems. But your exercise 1. made my eyes roll. Even with my short legs, it would be impossible with my orthopedically-challenged and stiff-jointed body. But I will figure out some approximation to it.

Thanks also to guest. I like to walk barefoot, but have a problem. Thanks to a Macquet procedure I had done in the 1980's, my left knee wobbles with every step I take, so I also like the support provided by shoes and boots. I suppose the knee-wobble could be causing or contributing to the PF problem, but I hope not, since orthopedic surgeons tell me there's nothing that can be done about it (Macquet procedures were a mistake they would like to forget).

The more advice, the better.

[drndr]

Stretching tends to be the number one thing. I like getting a golf ball or tennis ball and rolling it under my foot. Control the pressure to whatever you an handle and hit the entire foot. Especially arch leading into the heal.

D

[Perry]

Opinions vary, and people might have different causes and cures. In my past experience, I found that slowly stretching calves after some warm up helps but not stretching the arch. The large cutouts in the midfoot of shoes is fashionable these days, but that caused problems for me. I found that a continous outsole that touches the ground in the midfoot helped a lot (a small gap may be okay and helps on rock edges). Insoles with stiff arches can really help. I still wear them today for everyday walking and standing, but I don't hike or run with them because of risk of ankle sprains. Hope that helps.

[Ed]

Perry,

Thanks for the advice, I will be keeping your comments in mind. If there is anything I have learned from injuries, it is that while you have to start out following some kind of formula, people vary, injuries vary, and you have to learn and adjust as you go. Which is why I am interested in shortening my learning period by taking in other people's experiences.

[zippetydude]

Hi Ed and all you other fellow sufferers. I just might have some great news for you.

I came down with plantar fasciitis and it was debilitating. I tried all the things listed above for 6 months and could still hardly walk some days. I looked online and found basically the same options everywhere I looked. I went to my doctor (last, of course!) and he prescribed Voltaren gel, which has Diclofenac Sodium in it. I smiled knowingly. "I've pretty much found that creams and gels are either placebos or absorbed so little that they do nothing" I told him. He is very down-to-earth and said he had suspected as much himself when it came out. The literature seemed to indicate that this was actually an effective product, though, so he had gone ahead and prescribed it. He said that so far, the times he had prescribed it and had heard back from patients that most of them said it was effective. I filled the scrip.

I mostly followed the directions. It said to put it on 4 times a day and to put nothing over it for 15 minutes or so afterward. Well, it's my feet that I'm putting it on, and so I ignored the part about keeping them uncovered. In fact, to make sure my feet absorbed as much as possible, I actually put it on and immediately followed that by putting on socks. I did it upon rising (after my shower, of course, so as not to wash it off), at lunch, at dinner, and right before bed.

First day...nothing.

After 2 days...nothing.

After 3 days...slight improvement.

After 4 days...marked improvement.

After 7 days...gone.

I figured it was all better, so I quit putting it on. Mistake. It started to come back, so I started right back up. This time I kept it up until the tube was gone, about another 2 weeks. That was a year ago. It never came back.

I'm pretty sure it was the Voltaren, because the plantar fasciitis began to return right away when I discontinued use, then the pain evaporated a second time when I resumed treatment. I gotta say, I'm surprised this isn't common knowledge if it works on everyone like it worked on me. Months of stretching and pain and frustration - or a couple weeks of putting a little gel on the bottom of my feet? I just wish it wasn't prescription only, and at $50.00 or more per tube, it's not super cheap. But, since it worked, I would do it over in a heartbeat. When I discussed it later with my doctor, he said the only problem he's come across with it was patient compliance. If someone puts it on a couple times and gives up, it does not work. But 4 times a day, consistently, and it really worked as advertised. If you do try it, lmk if it works for you.

z

[Hikin_Jim]

Fascinating and good to know.

HJ