Injuries happen. It’s a part of the running journey. An unfortunate part, but a part that we all have to deal with at some point.
The most recent setback for me occurred right around December of last year and it is, I’d say, the most stubborn of injuries that I’ve had to deal with so far. The dreaded Plantar Fasciitis (PF). If you have had to deal with PF before, I’m sorry – I feel your pain. If you haven’t, let me give you a quick run down. Plantar Fasciitis usually presents as pain in the heel (I felt it more along the arch of my foot) and it is an inflammation or strain of a band of tissue that runs across the bottom of your foot (known as the Plantar Fascia). For me, I felt it most uncomfortable when first waking up, during running and directly after running. Any time I was sitting or lying down, there was little to no pain. It took lots of physio appointments and exercises, a lot of patience and time, but I am finally able to run with little to no pain and have even begun doing speedwork again. Here are some of the things that I felt helped me through this bout of plantar fasciitis but bear in mind, I am by no means a medical expert, I have simply talked with many physiotherapists, done many strengthening and recovery exercises – these are the things that worked for me. Please consult your own physiotherapists or medical teams for the real expert advice!
- See a Physio
I suppose the very first thing I would recommend for any injury is to visit a physiotherapist so that you can receive a proper diagnosis, treatment, and hopefully a good pre-hab, rehab, and strengthening plan. These are the real experts and they are the ones who keep us runners from falling apart.
- Calf Raises
After seeing my amazing physios, one of the main forms of exercise that I was prescribed were a variety of calf raises. Some done with my toes on the stairs and nothing under my heels, some while clenching a small-medium sized ball between my heels, and some with a rolled up towel under my toes. From my understanding, these calf raises are meant to strengthen the surrounding muscles that are not currently being activated (hence the pressure is on the plantar fascia to work harder). Even after my PF has seemingly been relieved, I plan to continue these strengthening exercises as pre-hab so that I hopefully do not run into my old buddy PF again.
- Mobo board and Big Toe Exercises
Aside from the muscles in the calf and surrounding areas (I do not know the technical names!) I was also told that my big toe is not working hard enough and this is, therefore, putting a lot of pressure again on my plantar fascia to overwork when running. If you sit down and cross your injured foot over your opposite knee, and then pull up gently on your big toe, you may feel a tug on that plantar fascia along the bottom of your foot (I know I certainly did!). To me, this was a clear sign (along with the expert advice from my physios), that my big toe was not doing its job during stabilization, or toe off in my running gait. To help activate my big toe, I was prescribed a variety of exercises, one for example, involved holding a stretched mini exercise band under just my big toes and performing calf raises so that the big toe had to keep contact and push downwards into the floor. Additionally, I was told of a wonderful tool called a Mobo Board by some of my physios. This board is like a wobble board with cut outs for all of the toes except the big toe. Balancing on this and performing exercises on it forced not only my big toe to work harder but I could feel all the muscles along my kinetic chain up my leg working double time to wake up.
- Cushy and Supportive Shoes
So if the previous exercises were all about pre-hab, rehab, and strengthening, what can you do to continue training (or sometimes even just walking) with as minimal pain as possible. The great people at BlackToe Running suggested a cushy shoe with just the right amount of support and I ended up with the New Balance 1080v11. A great shoe that I took on every single run while my PF was really hurting. If you are not sure, I’d highly suggest going to your local running store to see what they can advise (chances are that one of the staff members has gone through Plantar Fasciitis before!) https://www.blacktoerunning.com/blogs/education/which-running-shoes-are-best-for-plantar-fasciitis
- Recovery Slides Around the House
I had already been wearing a pair of OOFOS recovery slides around my house but even more so when my PF was at its most painful, I found walking around hardwood or tile barefoot to be unbearable. So, I would recommend wearing a pair of OOFOS, Hoka recovery slides, or even a pair of supportive shoes would be better than being barefoot.
- Roll On a Ball
This can also be a part of your pre-hab and recovery routine, but I found that particularly right before a run and right after a run, rolling my foot along a lacrosse ball to be very helpful both in terms of massaging the bottom of my foot as well as activating muscles before running. Using a squash ball (which is quite a bit smaller) on the outside edge of my foot also helped a lot as my physio found that because this outside part was so locked up, I was compensating more with my plantar fascia as my foot almost collapsed inwards far more than it should have been. Please don’t overdo it though with this, as once or twice I found out the hard way that yes, I could absolutely make things more painful by rolling too much. (tip! If it hurts to roll on a ball on hardwood floors, try on carpet as I found it to be slightly less firm along the bottom of my foot).
- Adjust Speed or Distance, Maybe Both
As you go along your training plan and try to manage fitting in your runs while also managing PF pain, I would recommend first having a conversation with your physio and Coach (if you have one) so that together, you can come up with a good plan to either rest completely for a bit or continue running in a smart way. What I mean by smart way is reducing either distance of runs, speed of runs, or both. If you find that speedwork aggravates your PF (as it did mine) then turn all those speed workouts into easy runs or even cross training. If distance is the thing that aggravates your PF then put a cap on your long runs for a bit. Ultimately, this is something that will depend on your own training and goals, but first and foremost your health should always come first.
Lastly, and I know this is probably the last thing you may want to hear if you are suffering from PF, but sometimes, the thing that you need the most to help alleviate the pain you are feeling from PF is time off from running. This is again a conversation you should have with your Coach and Physio but don’t be discouraged if you do need time off. I always try to keep in mind that it is better to take one or two runs off (maybe even one or two weeks or more off) than not make it to the start line at all. The first hurdle of a lot of training plans for runners is simply making it to the start line healthy. This will be my goal for my Fall race plans, and I’m hoping that even if I miss a run or two, that my overall consistency will still be there.
So, those are some of the things that I have learned, tried, and been successful with when dealing with my bout of plantar fasciitis. If you are dealing with PF, I sincerely hope that at least one of these things helps you. Try not to put too much pressure though on yourself, running progress is definitely not linear and injuries will always come and go but pushing through true pain may not always be the smart decision for you in the long run. And ultimately, I think that all of us really want to be life-long runners, and to do this, we have to first take care of ourselves physically as well as mentally.