TMTS - Plantar Faciitis

Discussion in 'Ask the Docs' started by jouno53, Oct 14, 2011.

  1. jouno53

    jouno53 Barefooters

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    Hello,

    My name is Ryan and I would greatly appreciate your advice regarding my current predicament.

    To give you some background – I have never been a runner, however, I have been doing Crossfit starting strength for about 4 months now, and after hearing about barefoot running, wanted to compliment my lifting with some natural running.

    About 4 weeks ago I purchased a pair of Vibram Bikila LS shoes and some Merrel Barefoot Trail Gloves to wear on a daily basis. Being impatient and irresponsible, I jumped into running 30 minutes a day with my Vibrams, alternating days for about a week. My feet and calves were killing me, but I felt like I was going somewhere, and I loved it! However, 3 weeks ago (Sunday, September 25 to be exact), my right ankle started to get incredibly sore and inflamed. For about a week, I had a bad limp as I walked around on my sprained right ankle, and the bottom of my right foot also began to hurt. It has been 3 weeks now, like I said, and my ankle and Achilles tendon are in substantially better shape. However, I believe I have developed plantar faciitis on my right foot, as my arch towards the front of my foot, and occasionally near the heel will start to hurt. It has been about a week since I have definitely pinpointed my right foot pain as plantar faciitis, however, it is not incredibly terrible or incapacitating.

    For the past week, every morning before I get up I stretch my right foot and massage it to prevent maximum damage from occurring when I get out of bed. Throughout the day, my right foot will have a dull pain, and I constantly stretch it.

    I have had to forego any sort of squats or power lifts that use my feet, because I fear that I will continue to hurt my right foot. I have also ceased running for the time being.

    What I am wondering is:

    1. Since I became injured, I have still worn my Merrel barefoot shoes and Vibrams on a daily basis. I no longer wear sneakers when walking – I wear my minimalist shoes for walking. Am I doing myself more harm than good by doing this?

    2. It has been 2 weeks since I have noticed my plantar pain. I will NOT get shots or take any symptom relieving medication. What can I do to benefit my healing?

    3. Assuming it is okay for me to continue to wear minimalist shoes during the healing process, and knowing that I will not be running while I heal, should I expect to eventually fully heal? I plan to join Air Force ROTC next fall, and pray that my plantar faciitis will heal before then, as it is a disqualifying injury.

    I greatly appreciate the time you have taken in helping me in this matter. I fully recognize that it was my impatience in building up the strength to begin barefoot running. All I desire is to heal properly and make the best decisions to enable me to have another chance to do this properly again.

    Sincerely,

    Ryan
     
  2. Haselsmasher

    Haselsmasher Barefooters
    1. Colorado

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    Ryan: I'll offer my opinion

    Ryan:



    I'll offer my opinion - however note I'm not a doc - let alone one of the docs in this forum. So take the following with a grain of salt and it will be good to hear what the docs say.



    I would tend to pay attention to what the trend of the pain level is over time. I think doing what you're doing is reasonable as long as the pain level over a multi-day period is not escalating. In my opinion the challenge of your situation is you want to strengthen while not aggravating the injury - and there is a fine balance there. If you can't get the pain calmed down it may make sense to wear more supportive shoes to provide an environment more conducive to healing. It's kind of like needing to immobilize a borken arm while the bone heals: Using some sort of support temporaily while things heal might be wise, but again I'd go there if you can't get the current pain level improved doing what you're doing.



    When you do some of your non-supportive shoe stuff I'd try some *real* barefoot walking outside. The nerve stimulation of real barefoot outside is way beyond what you get in a minimalist shoe - or even barefoot inside. That extra nerve stimulation from all the little pebbles, surfaces, etc. I think really helps in the muscle strengthening.



    Jim
     
  3. jouno53

    jouno53 Barefooters

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    Thank you very much for your

    Thank you very much for your advice, Haselmasher. My pain has gotten better, and I will continue on working to strengthen my feet and leg muscles to support barefoot/minimalist walking until I can run again.
     
  4. Dr. Andrew Klein

    Dr. Andrew Klein Barefooters
    1. Minnesota

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    jouno,Thanks for your

    jouno,

    Thanks for your question. I'll start off by giving you some hope. I think you'll be ok by next fall.

    Now, stop stretching your foot. The tissues are inflammed and are already stretched which is why you have the pain to begin with. By stretching, you are further irritating them. You may, and should, massage them daily. I use a rolling pin on the floor and roll my feet for a few minutes. You can do this a couple times per day. You should also do the rest of your legs while you are at it; calves, shins, quads, hams, IT band, etc.

    Next, start strengthening your feet. Use a towel on the floor and scrunch it up with your toes. You can do this seated and not put so much stress on the plantar fascia. Later when your pain is down you can move to standing and pick things up with your toes while balancing on the other foot. That gives the added benefit of dynamic strengthening. Also, do a lot of barefoot walking to strengthen your feet. The next step is some light jumping on a hard surface, landing as softly as possible.

    When you are pain free you can get back to running. Do it barefoot, not in vibrams or merrells. Go 200 meters and stop. If you have no pain, you can go a little farther the next time, so on and so on. Short strides, high cadence.

    While you are healing, take a little time to do some research on form. Here's a sort of "beginner's" post on my blog: http://barefootchiropractor.blogspot.com/2011/09/visualization-of-barefoot-running-form.html. Find lots of different viewpoints here at the BRS and on the thousand other blogs out there and you will find the description of form that makes sense for you.

    As I've said on other posts, barefoot running is a lifelong pursuit not a goal to be met. Take it slow and you'll be fine by next fall.

    If you are not improving, it is then time to seek some help. There is a Doctor Locator map here at BRS that may help you find a barefoot friendly doc near you.
     
  5. Dr James Stoxen DC

    Dr James Stoxen DC Barefooters
    1. Illinois

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    Hello there,

    PLANTAR FASCIITIS come from too much chronic STRESS in the plantar fascia of the foot. It starts with inflammation that turns into scar tissue that later calcifies.
    The question is... What is the cause of this chronic stress in your foot?
    In walking or running as you know there is simplistically the "take off" and the "landing". We all know the majority of STRESS injuries occur in the landings.
    Like a plane, the human body has a landing gear, spring-loaded shock absorbing mechanism built into the arch complex as well as the muscles that allow the foot to impact like a spring and not a bang.
    Foot Cuff: http://teamdoctorsblog.com/wp-content/uploads/2012/06/Suspension_Muscles_Bottom.jpg
    Foot Spring Suspension Muscles: http://teamdoctorsblog.com/wp-content/uploads/2012/06/Spring-Suspension-system-muscles.jpg
    The key is to
    · release the muscle spasms around the 33 joints of the foot, so they can move better. That allows the impact to be moe evenly distributed across the foot like a spring load instead of a bang.
    · Stretch the foot in a 3 dimensional plane so it is flexible to absorb the impacts of walking
    · strengthen the suspension system muscles or the pronation supination cuff muscles that suspend the arch so it works like a spring to spring you off the ground rather than bang you into the ground
    Here are some simple stretches and massage techniques you may find helpful:
    Scissor Stretching Of The Feet
    http://teamdoctorsblog.com/2011/08/05/video-tutorial-84-dr-james-stoxen-dc-demonstrates-scissor-stretching-of-the-feet/

    Deep Tissue Treatment Under The Big Toe And Second Toe
    http://teamdoctorsblog.com/2011/08/03/video-tutorial-82-dr-james-stoxen-dc-demonstrates-self-help-deep-tissue-treatment-under-the-big-toe-and-second-toe/

    Video Tutorial #80 Dr James Stoxen DC Demonstrates How To Self-Help Deep Tissue Treatment Of The Subtalar Joint Of The Ankle On The Inside.
    http://teamdoctorsblog.com/2011/08/01/video-tutorial-80-dr-james-stoxen-dc-demonstrates-how-to-self-help-deep-tissue-treatment-of-the-subtalar-joint-of-the-ankle/

    Video Tutorial #81 Dr James Stoxen DC Demonstrates How To Self-Help Deep Tissue Treatment Of The Ankle (Subtalar Joint Outside)
    http://teamdoctorsblog.com/2011/08/03/video-tutorial-81-dr-james-stoxen-dc-demonstrates-how-to-self-help-deep-tissue-treatment-of-the-subtalar-joint-of-the-ankle/

    Video Tutorial #87 Dr James Stoxen DC Demonstrates Self-Help Deep Tissue Of The Ankle Mortise
    http://teamdoctorsblog.com/2011/08/10/video-tutorial-87-dr-james-stoxen-dc-demonstrates-self-help-deep-tissue-of-the-ankle-mortise/


    Here are my last two articles you might find helpful:

    How Does The Body Spring Back Safely From Impacts Of Running and Walking?
    http://teamdoctorsblog.com/2012/06/13/video-tutorial-12-is-running-bad-for-knees-how-the-body-springs-back-safely-from-impacts-of-running/

    Self-Tests & Exercises To Reduce Over Pronation and Over Supination From Impacts During Walking and Running
    http://teamdoctorsblog.com/2012/06/18/video-tutorial-28-the-impact-absorbing-landing-muscles-of-the-human-spring-mechanism-testing-and-training-the-spring-suspension-muscles/

    Dr James Stoxen DC, President, Team Doctors The Barefoot Running Doctor
     

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