Plantar Fasciitis update: I got my cast off but I can't run...yet

posted by Musings from a Multisport Mama
Wednesday, October 28, 2009 at 12:16am EDT

A multisport blog by a multitasking mom in graduate school for anthropology and part-time web designer with 2 awesome kids and husband. I've done 2 IMs, 1 ultra (50K), 17 marathons (w/Boston), and too may triathlons to count since 1988. Lately, my fitness challenge is healing two injuries: plantar faciitis (left) and hip bursitis (right). I write about the cultural and physiological aspects of the sports of running and triathlon.

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I got my cast off today. I posted a photo of my cast-freed atrophied leg on my Facebook page with the caption, "Yikes! The horror! The hair!" The leg is cleanly shaven and sterilized with antibacterial soap now. Thank goodness.

Here is a summary of what my orthopedic surgeon told me that I need to do in order to go back to running long. If you are suffering from plantar fasciitis, I will tell you right now, I don't have the answer. I only know what didn't work for me. This is the second time I've had it this bad where I had to completely stop running for over a month. The first time was just after I got Achilles Tendonitis in the last mile of the Chardonnay 10 mile race in 1995. (I think it was from under-training, not stretching before the race and from wearing racing flats for the first race of that year.) It took about four years and two non-running periods of pregnancy to get rid of it (the plantar fasciitis) the last time. The Achilles problem only lasted about six months.

"You still have plantar fasciitis," said the doctor.

So, that means that I still need to sleep in a night splint, wear my store-bought orthotics (Superfeet and Spenco), can't wear flip-flops, and can't walk around barefoot. My foot doctor wrote me a prescription for physical therapy, 3 times a week for 4 weeks. The doctor wanted me to wear the felt heal lift I got from his office, too. Unfortunately, it doesn't fit in my shoes with the arch supporting orthotics and my husband cut a hole in it. I asked him to cut a hole in it because the pressure of it was hurting the inflamed area on the front of my heal in September--before I got cast. So "no go" on the $58 felt heal lift thingy.

"It takes about 10 months to get rid of it."

Okay, so does that mean I count 10 months from my first blog p osting about it? Or, when I stopped training with Inside Track, June 28th? I stopped running all together the day after the Carpinteria Triathlon, when I got my cast on, September 28th.

Crap! That means I won't be back at 100% until May 2010. :(

I'm going with the first blog posting date, minus one month. That way, I will be back at 100% in March. That's not really scientific but I'm an optimist. (That's me at the Carpinteria Triathlon in the photo on the left. Not in the photo is my daughter yelling, "Mom! What the heck?! I thought you weren't going to run!" The ambulance in the photo is significant. It is symbolic of the damage that I did to my foot that day. Next time I will listen to my kids. Photo by Christine Paone)

"Before you can run, you need to walk."

Here's my walk-to-run training regime per my doctor -- as I remembered it (I was still in shock at the time after he said, "it takes 10 months to heal...":

1st month: I need to walk up to a 1/4 mile the this week, then the 1/2 mile the second week and by 4 weeks be able to walk 2 miles.
2nd month: I need to then add 1/4 of slow jogging (8-10 mpm) then walk 1/4 mile and so on the second month. By 8 weeks, I should be able to jog 2 miles--pain free.

"This will get you running again but you won't be able to go back to doing 10 mile runs until March."

:(

"You need to strengthen your left leg."

But before that I need to do the calf (soleus) stretching exercises several times a day. Here's how:

Stand facing the wall with feel comfortabley apart (8-10 inces) Put your left foot about one foot length away from the wall (about 10 inches), toes pointing straight towards the wall. Put your hands on the wall and push back so your weight goes on the left foot. Keeping your back straight, slowly bend your knees, keeping your weight on your left foot. Hold this position 30 seconds before slowly rising to a standing position. Switch to the other foot and repeat. (The image on the left is not correct. The feet need to be closer together. The back foot's toe needs to be just behind the front foot's heal.)

Strengthening exercises:

Calf raises
Wall hamstring strengthening exercise. We called this "The torture chair" exercise when I was in Track and Cross-Country in High School.
Calf raises over steps--later when my foot gets stronger
Do the leg extensions to strengthen the quads and hamstrings in the gym

"Your range of motion is much better after four weeks in a cast."

Apparently, my left Achilles tendon and calf muscles were so tight before he casted my foot into a 90° angle, that he could not dorseflex it (push my toes towards my knee) more than a few degrees. Now I can flex my foot up 10-15°. The cast helped to loosen a tight Achilles tendon that was causing me to repeatedly strain the plantar fascia. The night splint wasn't enough.

"You will be able to run again and do ultras and race triathlons again. No problem. Just stay positive. "

Actually, he didn't say that. But I wish he did.

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There are 9 comments on this post. Join the discussion!

lovemyjake says:

I could really use your advice right now. I am scheduled to go in in 3 days for a cast. Have had pf for a year and a half, this is my last ditch effort treatment.
Could you drive with your cast on?

Monday, November 9, 2009 at 2:13pm EST

fredsal6 says:

Here are some additional plantar fasciitis exercises; I suggest you do the regularly, and you'll see a big difference. Good luck!

Friday, November 13, 2009 at 6:39pm EST

multisportmama says:

Dear "3 days until casting":
I'm sorry it has taken me a week to reply to your comment. The cast didn't work for my plantar fasciitis. Sad to say. My heal hurt just as much a week after I got the cast removed (it was on for 4 weeks) as it did before the cast. Now, 3 weeks "post-cast" my heel is less sore but that could be due to the twice weekly PT sessions. Each PT session consists of : stretching exercises, isometric/balance and dynamic strength training exercises of my foot and ankle muscles followed by ultrasound, deep tissue work and then ice for 10 min. My foot is less painful. I walk around in a pair of racing flats, Simple Eco shoes or mocassins with my Superfeet insoles. For exercise I strength train and swim. No running. Good luck.

Tuesday, November 17, 2009 at 6:03pm EST

lovemyjake says:

I just got my cast on yesterday (12-2). I'm so hoping it will work-in February it will be 2 year since I got PF. SOOOO long!
Secretly I'm not sure how the cast is going to work. My heel hurts in the cast right now, the same as when I was walking in shoes.
Something has got to give.

Thursday, December 3, 2009 at 5:52pm EST

multisportmama says:

Dear "Lovemyjake",

Gosh, I'm so sorry to hear that you have suffered with plantar fasciitis for two years. This injury is a real stinker. I had my foot casted for 4 weeks and the pain went away the last week while my foot was still in a cast. The last day of casting I went for an hour hike and I think I strained it again--even though much of the hike was me hopping on my good foot. Fingers cross that I didn't re-injure my PF foot that was sore from the hike, I got the cast off the next morning. My foot was throbbing pain, with the cast off. Dang! Now, I've been doing physical therapy for a month now. The plantar fasciitis pain is still there, but less sore. At least I'm stronger than ever before with the twice weekly PT/pain sessions. Hang in there and don't give up. I'm not. This is the second time I've had PF. It took a few years (2-4) before I could train for a marathon again. :)

Thursday, December 3, 2009 at 6:30pm EST

stephaniemp says:

You have an awesome attitude about all that you've gone through injury wise. It really is tough to keep your mind set on that goal while being patient in the mean time. Good luck with things to come!

Wednesday, December 9, 2009 at 5:25pm EST

maggikelly says:

I have been suffering from PF for almost a year. 10 months. Scheduled to go in for a cast in 2 days.
I've done cortisone, PRP injections, walking boot, crutches, accupuncture, massage, Active Release Therapy, sleeping boot, NO running. cycling even seems to hurt it. At this point I am giving all athletics up for 4-6 weeks in hope to heal this.
I am an ultra runner, long distance cyclist, swimmer, triathlete, and am really having a hard time emotionally handling this.
I am doing all the PT, taping and icing. Not sure what else at this point.

Monday, July 23, 2012 at 5:19pm EDT

multisportmama says:

Hi Maggi,

The cast didn't work for me and actually, after 30 days of my foot being totally frozen in a cast the muscles and tendons atrophied and then I had more bio-mechanical problems to fix. The cortisone injection didn't work either for me.

I have empathy for your frustration with this injury!

What worked for me finally:

1. Stopped running and walking barefoot (weight training, core work and swimming were my workouts)
2. Only wore shoes with my custom orthotics or a cheap heal insert for months...
3. Slept and rested in a Strasbourg Sock splint; It kept the facia stretched while I was sleeping or resting (and less likely to re-tear)
4. DEEP tissue work on the affected area (bottom of foot, Achilles tendon, calves 1x week by a professional sports doc (Wilson's Chiropractic in Ventura, CA) followed by ice/elevation (no more than 20min). I also saw a Rolfer for 6 months with a $150 session each time. The pain went away but I could not afford to go more frequently. Basically the deep tissue work broke up the adhesions that were causing me pain and inflammation in the area and caused normal tissue re-growth.
4. Deep tissue done by myself or husband almost every night on the affected area b4 going to sleep
5. Took NSAIDS and 20 min ice/elevation routines when experienced plantar fasciitis soreness

And, that fixed my foot in 3 months. All fixed now.

However, it took me about a year before I could run again without my custom orthotics. It's only now two years later that I can walk in regular flipflops again. (Before I could only wear FitFlops with the elevated heel). Re: the flipflops/shoes: I still can't walk in anything with a negative heel height. I can walk barefoot now tho.

Good luck!!!

PS: Don't let the doc do surgery. And, personally, I wouldn't do a cast either. I still had plantar fasciitis pain after my foot was in a cast for month. Also, the cortisone shot didn't work for me either. :\

Monday, July 23, 2012 at 6:00pm EDT

johnedwards03 says:

its cool

Monday, July 30, 2012 at 3:25am EDT

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