Monday, May 16, 2011

The Plantar Fasciitis Monster

After the Flying Pig Marathon in 2008, my right foot staged an angry revolt. For several weeks, I stomped around with an irritating “rock under the heel” sensation. When I broke down and went to a podiatrist, the foot was diagnosed with a textbook case of PF. The treatment was a nightmarish cortisone shot to the affected area (can you say 10 on the pain scale?), some static stretches to be completed before and after running, and a custom (read expensive) pair of rigid orthotics to be worn AT ALL TIMES during the waking hours. The diagnosis was also accompanied by the warning to never go barefoot and absolutely no flipflops. To do so was to risk permanently damaging my feet.

This seemed unnecessarily dire, but visions of my old self gimping along in a walker due to wearing flipflops haunted me. I tried to be a good patient. I had been cautioned to break the orthotics in gradually. I did. Running in the darned things felt like I had tennis raquets strapped to my feet. My legs ached and protested. I switched shoes. Walked more. Took them back for an adjustment. In the end, there was no getting comfortable in the damned things. Besides my running going straight to hell, my feet got lazy and weak. Stand on tiptoe? Forget it. All the life had gone out of them.

Eventually I ditched the orthotics, switched to Nike Frees and went barefoot as often as possible. Over the course of a summer, the PF first receded, then went into dormancy. I felt I had won and pummeled the monster into submission. Anytime that the foot began to complain, the sure cure was to back off running for a couple of days and alternate between the Frees and a pair of Lunar Glides. This worked without fail.

After the Gasparilla Half Marathon in February, my right foot started aching again. It was a little different, more along the side of the foot, but it seemed plausible that I had angered the PF monster and it was lashing out in a new and different way. Not a problem, I thought, and took a week off. Take that, PF.

Things did not improve and in fact were worse after a week. An attempt at a one mile stroll around the block was so uncomfortable that it occurred to me I might have a stress fracture in the foot. A phone conversation with a physical therapist friend suggested the possibility of a fifth metatarsal issue, possibly a fracture.

Scared and unhappy, I made an appointment with a sports ortho guy. An X-ray quelled the stress fracture threat. It was not a fracture, and indeed, not even PF, but rather a case of the dreaded tendonosis, brought on by overly tight hamstrings and Achilles tendons. WTF? This is foot pain, my hamstrings are just fine, thank you.

Simple really, as I learned in PT sessions over the next six weeks. Running can screw up hamstrings and in really unpleasant ways. You have to do things to keep them flexible. This becomes more crucial with aging. Left to its own insidious devices, the hamstrings and achilles tighten and tighten and pull against tendons in the foot. You get some tendonitis out of this. Time goes on, the aggravated tendons and ligaments form scar tissue.

Now you have tendonOSIS. Continue to ignore this (although how you could is beyond me because it's pretty uncomfortable) and calcification sets in. I don't want this.

So now the daily drill is a series of exercises designed to stretch out the hamstrings and achilles. It goes like this:

- 4x around the dining room/kitchen loop

  • Walk on tiptoes

  • Walk on heels with toes up

  • Straight legged walking

  • Traveling lunges
- Stand on steps and let heels sink down, stretching hamstrings, hold for 2 minutes
- Lie on floor with leg up against the wall, stretching hamstrings - 6 x at 30 second each
- Lie on floor, stick leg straight up in the air, loop what looks like a dog leash around foot and pull it - down hard, 1 minute each leg
- Kick forward 10x, then backward 10x, then sideways 10x
- Core work on the ball

When this is done, I sometimes have time to get a run in.

No comments: