Top Five Friday: Plantar Fasciitis Rehab

Weeks have now passed and my trusty running shoes are gathering dust. Granted, my poor housekeeping skills mean my running shoes accumulate dust even when I’m using them on a regular basis, but the metaphor applies.

The cautious course of treatment for my plantar fasciitis has kept me exclusively on the bike and in the pool, but my return to the run inches closer every day thanks to rest and the rehabilitation efforts of the guys at Fitness Sports & Physical Therapy. Through my sessions I not only see toes move on their own through electrical nerve stimulation, I have the opportunity to learn.

And so, Friday’s Top Five returns with what I’ve learned at physical therapy.

1. I should have taken an anatomy course.

Before the injury, my knowledge of my foot was limited to identifying my toes, heel and Achilles’ tendon. Now, I actually know what the plantar fascia is — a thick band of tissue which connects my big toe to my heel. More than just naming parts of the foot, however, I learned that while the body can repair itself, it sometimes doesn’t do it as efficiently as we like. As described to me, the scar tissue on my plantar fascia is like knot of spaghetti. The goal of the therapy is to urge that scar tissue to line up with the rest of my foot while also decreasing the inflammation which is causing me pain.

2. The heat vs. cold debate

The podiatrist advised rolling my foot over ice each day. The physical therapist advised heating up a water bottle and rolling it over the warmth.

Which is it?

Both are effective, but it depends on the timing. Ice is best immediately after an injury to decrease swelling and inflammation. Every time I exercise, there is a chance I’m aggravating my plantar fascia and so rolling it over some ice can be helpful. But my particular injury occurred a while ago, so using heat can actually promote healing by loosening up the area and promoting blood flow.

3. My arches are on the high side

I don’t exactly have classic “high arches” but Scott, my physical therapist, noted that my arches are a bit high. Which is better overall: Flat or high arches? Turns out flat. The flatter the arch, the more flexible the foot. The message for me? My beloved K-Swiss may not be giving me quite the support in my arch that I need. (And yes, that was a big “I told you so” from Best Boyfriend Mark you heard just then.) My return to running will also become a return to Asics.

4. My feet are in good shape, kind of

Overall, my feet look good for someone who has put on the miles in the last four years. Runners’ feet can become gnarly and problematic and right now, mine still have plenty of cushioning between bone and skin and few potential problems.

But there are potential problems. Scott noted that my plantar fascia in my left foot is actually a bit tight, signally that I could be in for a similar situation in my current “good” foot. Preventative measures, like stretching my calf muscles and doing rehab work on both feet, will hopefully keep that problem from materializing. Additionally, the buildup of callouses under my big toe indicates that I’m landing heavily on that part of the foot. And the front end, it turns out, of the plantar fascia. (Back to the need for that anatomy class.)

5. It pays to have people on your side

One of the reasons I decided to train with a coach was because I needed guidance when my inner dialogue became too confusing with options, “what ifs” and “buts.” Am I being too “soft” by taking extra time off to heal from an injury? If any other person asked me that, I’d strongly answer in the negative, citing the long-term goals of running (and cycling, swimming, etc.) as a lifetime lifestyle. Putting myself in the equation can muddle that previous clarity. But my coach (and others like him) won’t let me return to running sooner than is prudent, and, knowing him, will make me take my re-entry slowly. If nothing else, I’m learning the art of patience.

One Comment on “Top Five Friday: Plantar Fasciitis Rehab

  1. One of the reasons I decided to train with a coach was because I needed guidance when my inner dialogue became too confusing with options, “what ifs” and “buts.” Am I being too “soft” by taking extra time off to heal from an injury?