Thursday, August 23, 2012

Plantar Fasciitis: Cure and Pain Relief FAST with the Kitchen Sink Prescription

Those of you who know me, know that I'd been whining - it seems like forever - about not being able to run because of Plantar Fasciitis (henceforth referred to as PF). After over half a year of trying everything recommended by friends etc, with no apparent relief, I quite suddenly found the solution to my PF! It might be yours too!


How I got Plantar Fasciitis
As I weaned off the meds, as my body healed from half a lifetime's worth of major health problems, I rediscovered my love of Running - in a big way. I'd pack my Camelbak Skeeter with water, dodol ('Malaysian Gu Chomps'), a few ringgit, phone, and first aid kit, and take off into the FRIM Bukit Lagong forest behind my apartment, running for 6 - 7 hours at a pop (don't be impressed - I'm just really slow hehe). I never wanted to stop.

But I had to. (Dang you PF!)

In my eagerness to run more and more, I had done too much too soon. The over mileaging - even in the minimal running shoes that greatly helped my arthritic knees - had over-stressed my feet before they had the chance to adapt and and get stronger.

The run that 'broke' my feet was probably the MPIR run in Jan early this year, where I went out in a blaze of glory - I actually won something for doing something athletic, for the first time ever! That evening, the sharp shooting pain through the heel of my foot began, and it didn't go away for the next seven months. Plantar fasciitis? Bone or heel spur?

Most of you are already familiar with PF symptoms (e.g., heel pain especially in the morning and after periods of sitting/inactivity), so I won't go into detail here but will save that for another post.

I think I pretty much tried everything except steroid shots (cortisone injections), extracorporeal shockwave therapy (ESWT) and surgery. Below is what I felt helped and what hurt my efforts to recover. And also what gave me almost instantaneous relief and The Cure :)


What Not to do for Plantar Fasciitis
I was informed by the physio doc that I should lay off running because the PF would not go away otherwise. It seems my years on steroids predisposed me to PF because the steroids hastened aging and had caused the natural fat pads at the bottom of my feet to deteriorate. With no cushion, the plantar fascia is susceptible to bruising, damage and inflammation.

I stopped running (which I actually didn't need to - read on below).

I wore cushioned shoes 24/7 - from the time I woke up till the time I went to bed, even in the house (shouldn't have). This was supposed to protect my feet while giving relief from the heel pain. All that cushioning did help my pain, but the PF didn't go away. Interestingly, my lovely high arches disappeared. At the end of six months of practically living in my shoes, I had become flat-footed! I now understand that all the little muscles in my foot - when I was barefoot - work together to give that 'spring' to my step. Cocooning them in shoes made the foot muscles weak. The muscles supporting my arch no longer did, so my arch flattened out. (I understood this phenomena better after reading Born to Run).

I got custom insoles (hard and painful, PF stayed) and tried off-the-shelf insoles too (pain relief but PF stayed). The physio doc said those $100 hard insoles would provide support to my arch, taking pressure off my heel. They hurt my arch and my heel. My pain threshold is up there, but I lasted only a week in those things. The Dr Scholl's Pro Pain Relief insoles were nice and cushy (and muuuch cheaper), but didn't seem to be doing anything to make the PF go away.

Awful. Just awful. 


What To Do for Plantar Fasciitis (What I did anyways)

For the first six months I did things that I think helped, but didn't resolve the PF:
  • I stretched. Especially calf stretches. The physiotherapist I saw at HUKM taught me a few good plantar fascia and calf stretches (will cover these in future posts).
  • I massaged my feet and calves. This was well and good, but as I didn't really know what to do at that time, it didn't resolve the PF.
  • I iced. This was torture. I'd soak my feet in a bath of really cold water to bring down the inflammation. 
  • Night splints (the plantar fasciitis boots). This was really the most effective way to keep the PF pain manageable and at bay. It works by keeping the plantar fascia extended while you sleep. I also stopped sleeping on my tummy. Sleeping on the stomach results in the feet being pointed and the plantar fascia kept in a shortened state for long periods of time (baaaad).
At Month Six, I started seeing a chiropractor. This was Dr Scott Mills, who specializes in treating athletes. That was when things started to get better. 

The New Balance Minimus
  • Barefoot exercises. Scott prescribed a series of exercises to strengthen my feet. These worked the little muscles in my feet, and I was to do them on grass. They took about 20 minutes everyday. (Will cover these in my next post). 
  • I finally ditched my shoes and started going barefoot as much as possible. And I went back to wearing my beloved New Balance Minimus and other minimal shoes that allowed me to feel the ground. 
  • Active Release Technique (ART). Scott used ART to perform a controlled break down of the scar tissue surrounding my plantar fascia. He applied pressure all along the plantar fascia while manipulating my foot at certain angles. The aim was to actually start some fresh inflammation in the area so that healing begin could occur.
  • Icing. Icing was now done in the evenings, particularly on days I received ART treatment. It was to bring down the inflammation caused by the treatment (think of it as a 'controlled inflammation'). 
  • Night splints. I continued wearing them.

After a month of all that, the scar tissue on my heel had dissipated for most part, and I was really pleased about that. However, I still experienced heel pain after periods of sitting down, and I still needed to wear the foot splints, else the morning heel pain would be present.

Fast Plantar Fasciitis Relief - Trigger Point Yourself

At the end of June, as my PF treatments with the chiropractor were wrapping up, and with heel pain still present, I read the "Trigger Point Therapy Workbook: Your Self Treatment Guide for Pain Relief" (2nd edition, by Clair and Amber Davies).

I applied pressure to and rubbed at the specified 'trigger points' in my feet and calves that the book said would help with PF. And the pain vanished. Just like that. I kid you not. I was stunned. It really worked for me. The next morning, I woke up for the first time in ages not wearing my PF boots - pain free.

It might help you too. It's easy to do, takes just a few minutes a few times a day (gosh, I'm sounding like a salesman but this book has like, 396 gushing reviews on Amazon ya know). The book contains helpful diagrams showing where the trigger points are in relation to the 'referred' pain, for pain in various parts of the body. I've definitely got more posts planned on this topic.

I think it is interesting and relevant that the book says to think of your calf muscles as extensions of your foot muscles.

"You may not have ever thought about it, but the eleven muscles of the lower leg are actually foot muscles. Anatomists call them extrinsic foot muscles, meaning they operate from outside the foot. The muscles in the foot itself are intrinsic foot muscles, meaning they work from inside the foot. The implication of these facts is that the pain in your feet may not be coming from your feet themselves. You can waste a lot of time rubbing and soaking feet if the cause of your pain is trigger points in your calves and shins."

Progress, Finally!
I'm back on the trails! I'm running again. No more pain. No more foot splints. In fact, I trigger point myself whenever I have knee pain or any sort of pain anywhere in my body. To say I'm sold on trigger point now is an understatement.

Do you have plantar fasciitis pain? Has anything worked for you? Would love to hear your PF tale of misery and victory. Leave a comment!

xo Gracie

p.s. It would be GREAT if you could click on any ad here - my sponsors give me a few cents per click. Thanks for supporting my blog!

23 comments:

  1. Shall try I will. Trigger point massage, I learn

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    1. Man, Stupe, this trigger point seriously works on so many things it's ridiculous. Any Injuries bothering you? I'll look up the trigger point book and see if we have anything in there for you.

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  2. cool!!!!!! i want that book!!!!!!!
    dun hv PF....coz i swear those short mileage in my vibrams for all those months helped.....but a damn useful tool to learn for work!!!!!

    btw...when ru coming back, gracie?

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    1. Pui San!! I remember you advised me 'no hills, short runs only, and s-t-r-e-t-ch', and that that worked for your pf at one point too. I'm really thinking of getting vibrams again - will have to save up for that since I'm kinda broke hehe. Hey, if you order that book, go through my Amazon link babe! I get like, 4% or something! I'll gladly carry it back to Malaysia for you if you can wait till March next year hehe.

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  3. Thanks Grace for the sharing! Shall try out the trigger point technique.

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    1. Francis! Ya, I'll be posting the pics on specifically where to apply pressure (trigger points) for plantar fasciitis next. Do you have any muscle pain anywhere - I can check the book to see if the pain is referred pain from trigger points. :)

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    2. Hi grace, Thanks for your posts...
      I have been an active pharmacist for 17yrs, have been dealing with pF for 2yrs, and it has stopped me from working last 8-months :(( My pain is bilateral R worst than L and it is debilitating.
      I have done xray, MRI, custom orthodics, injections, seen over 10 specialists, pain meds, OTC orthodics, online gadgets, compression stocking, compression sleeves, high arch shoes and sandals, icing, heating, night boot, Yamana foot savers, massage, PT, tapping, ....Anyone out there with any advise short of surgery, PLEASE HELP and email me! shamdoneypharmd@gmail.com

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    3. Hi Shamdoney, sorry to hear about your suffering. It looks like you have tried everything except going barefoot and doing the barefoot drills that in my case, helped cure my PF (along with trigger point therapy). Email me - let's talk about how we could alleviate your PF pain.

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    4. Grace how do I get your email address?
      Please email it to me: shamdoneypharmd@gmail.com

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  4. Hi grace,

    It's glad to know you are on your feet running again.
    Days without the ability to do so must be really miserable.

    I thought of getting the book just for the point of some muscles / joint maintenance. Or it is mean for treating injuries only?

    I been hearing this for quite a while lately.. Trigger point is also very relevant in Chinese acupuncture too right?

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    1. Eldred, dude, seriously, you need to get this book. It's going to help maintain your muscles and joints in good condition, especially those leg muscles of yours that you have been working so hard. Since you don't have a personal masseuse at the moment, you can add trigger pointing to your self-massages. For calf tightness, I find trigger pointing is much more effective in releasing the muscle, then after that I follow up with sports massage plus stretching. If you order the book, pls order through my link ya! xoxo

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  5. I have had PF for 3 years and nothing is working. I have pretty much tried everything you listed above, except I just recently had plasma injections in my foot. So far, that is not helping either. I ordered the book and really hope it helps. I was still running up until a few months ago because now I can barely even walk it hurts so bad. Thanks for your blog post. Would love to know if it is still working for you?

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    1. Hi thanks for your question and so sorry to hear you can't run pain free at the moment. Yes my PF is totally gone and whenever it feels like its coming back I trigger point it right away and keep it at bay. Also, I'm now applying it as a first line of treatment in my sports massages and it has never failed to work on everyone who has PF. Take a moment to read my other detailed blog post on specific trigger points (locating and deactivating) for PF if you haven't yet. And if you have any trouble finding them let me know and I'll help you best I can. Hang in there!!

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  6. Hi Gracie. Thanks for you posts. I did click on some of your ads to help you out. Thank you for your info. I've had surgery for pf, tts, and baxter's nerve entrapment. Been 3 months and still having pain. Am trying these trigger points, and almost a continuous stretch by using the splint day and night. seems to be helping soon. It has been almost 2 years since I have been able to walk without my feet screaming at me! I've tried almost everything there is to try. It is so discouraging, I do know that. Especially when you are not a "sit down" kind of person. Take care, P.

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    1. Hi thanks for your comment and encouraging words! So sorry to hear about all the awful pain and surgery you had to endure. I'm positive that trigger pointing will help alleviate some if not all of that pain. I have a specific blog post on trigger pointing for plantar fasciitis that shows exactly where to massage for immediate pain relief - let me know how that works for you. Thanks for clicking on the ads you are awesome!!

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  7. OMG if this works, you are my new BFF. I could tell your story EXACTLY. I am desperate for help b/c nothing so far has worked and I'm sick of wearing shoes 24/7!!! I stopped running a week ago and my PF hurts worse now than ever. What is UP with that? I am ordering the book. Thank you!

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    1. Jo-Lynne thanks for your comment. I totally feel your pain! Stopping running won't necessarily help either as I found out, which was so frustrating. I've another more recent post on the specific trigger points for heel pain that will point out with pictures where to massage. Let me know if that works for you!

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  8. ooohhhhh, thaaaaanks!!! I'm gonna do everything that you are saying! Having PF after one year in a half..... NOOOTTTT A HAPPY PERSON!!!

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    1. Thanks for your comment - would love to know how it goes for you!

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  10. Hi Grace, Thank you for the article. I read like mad on internet and came upon it. Am in process of trying it. My question: I see that you wrote this in 2012. How are things 3 years later? Did PF return? Any follow up information?

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    1. I'm PF free for most part - it sometimes starts to come back if I sit too much and in those rare times a quick trigger point rub eliminates that. Try the trigger point therapy and barefoot drills plus stretching, and let me know if it helps!

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  11. This article very useful.I LOVE this page.
    Thanks Grace for the sharing! Shall try out the trigger point techniqu

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