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

The Rachel Carson Trail: Secret Treneng Files

The past two weeks I have been running every few days at the Harrison Hills Park. Nothing major, as I want to be careful to prevent Mr Plantar Fasciitis from rearing his ugly head. I've also been trigger-pointing myself throughout the day and that has effectively stopped my heel pain. (I promise I'll blog about my plantar fasciitis cure soon. Promise!)

Today I decided to try a section of the Rachel Carson Trail, which conveniently starts right next to our home. With the Rachel Carson Trail Challenge (34 miles) fresh in my mind, thanks to my ultra marathon buds Ben Brucker (who won first place - out of 582 participants - with a sub seven hour time), I now harbored some vague hope of attempting it next year :p

I'm going to call it the Rachel Carson Obstacle Course. In the short 5 km section of trail I went on, I had to climb over 6 fallen trees, ford two rivers, flee from a mob of feral horses, a rafter of turkeys, assorted deer, a rabid fox and other wildlife!!

Ok, well, I'm exaggerating just a bit, about the river crossings. They were just little streamlets. 

And ok, the horses weren't wild, they were just trying to be friendly. 

Just seconds later I was fleeing for my life as the horses started running towards me. Maybe they wanted a carrot.

But I had to cross an electric fence. For real.

Nathan Intensity Race Hydration Pack for Women: Buy or Not?

I'm *this close* to buying this pack. I'm finally (thanks be to God and to trigger point therapy) back on the trails pain-free again, and my existing packs (Camelbak Skeeter, Reebok, Salomon etc) ain't gonna cut it for my planned longer runs.

While there is the newer model (2.0) of the Nathan pack, this partickular one is on sale, and it receives glowing reviews from a bunch of satisfied reviewers. About 99% of the reviewers on REI use it for their ultramarathons. Maybe if I possess this pack, I could also somehow run an ultramarathon too! :p

Ok, gotta do some preventative plantar fasciitis triggerpoint therapy now.

xo Gracie

Multi Purpose Insurans Run 2012 Report

The MPIB run (or MPIR) held this morn 8 Jan 2012 was superbly organized, with plenty of water and 100+ stations, and a huge contingent of enthusiastic volunteers. These volunteers were constantly plying us with drinks, snapping photos like paparazzi (but nice paparazzis ya), and generally making sure all 3700 runners had the best race possible. The only thing they didn't do was help me to run this thing! (Read a volunteer supervisor Frank Chong's report HERE)

And oh my, the goodies - race kit had a whole box of Nestle Fitnesse Cereal (not those little dinky samples), good quality New Balance running tee, and 20&50% discount vouchers for New Balance and Sworke sunglasses (anyone want mine FOC?). Finishers race bag had High 5 sausage bun, water, banana and mandarin orange. We also had Nestle Tropicana Lime ice cream, and free flow of Milo, Nescafe, Fitnesse Cereal with milk, and 100+. The registration fee of RM48 (late bird) certainly got us a lot.

The 12 km race route included the 'Reverse Double Hills', which is supposedly 'easier' than the Double Hills. The route was extremely pleasant running, and throwing in the bonus hills makes it challenging and memorable. Now this is just a newbie's opinion (mine). I have taken part in only one running race here (the Putrajaya Night Marathon 2011), and was never much of an athlete back in school days, but I think it's fair to say the organizers put together a race that is going to be a staple 'must do' on the local runners' calendar in future years. Here's the route below:

FRIM Trail Map & Entrances

Hey folks! I have heaps of stuff I would love to post about, but wanted to get this out right away, so here you are. I've marked four entrances to FRIM: the KBG (Kepong Botanical Gardens) entrance charges a smaller fee than the FRIM Main Gate, and parking there gets you closer to your Steroid Hill run/bike. (More info on KBG and FRIM).

I'll update with more trails as I continue to explore. Come join me for a run some time! :D

A click on any ad below this post will put a few cents in my pocket, from the advertisers. Thanks for supporting my blog!

xo Gracie

Can Swim Straight?: Port Dickson Open Water Swim and other happenings

Whoa my last post was nearly three weeks ago! It’s been BUSY! I was going to get busy again today with a trail run in FRIM then it started chucking down rain, so I thought I’d dash off a short note here. But first, here's a route map of the PD Open Water Swim that I yak about at the end of the post:

Errr.... I can explain this (see end of post)

Putrajaya Night Marathon Make That Change Reality Show: My Thoughts

Summary of Post
What I think of this whole Reality Show Contest thing. My personal struggle deciding which entry to vote for ('what, you don't vote yourself ah?'). A voting strategy that I feel comfy with now. And a pledge, if by some miracle I win, half goes to my friend with SLE, and half goes to Jiana's friend with DLBCL Stage 4 cancer. Be warned, a rambling blog with no pics!


Back in July

I was approached by Anand of Hooha.Asia to be in a video promoting the PNM Make That Change Reality Show.

I didn’t hesitate to say ‘Yes, I want to help’. I have wanted to run for SLE for ages (but was held back by my own illness), so this was a great chance to help raise awareness of this killer disease. The result: Make That Change Promo Video.

In the video, I was the friend who wanted to help another friend, who suffers from a lifelong autoimmune illness called SLE (Lupus). Viewers were asked to think of people in their own lives who needed financial help and to submit a 90 sec home video highlighting their ‘cause’. The five best submissions would be interviewed and re-taped. Then the official videos would be open to public for voting. A RM6000 cash prize would be awarded to the person/cause voted by the public as most needing the money (read more HERE).

This promo video, and also another sample video were publicised on Hooha.Asia, emailed to everyone who signed up for the PNM and etc. I thought there are 10,000 runners in the PNM, if 1% answered the call to ‘Make that Change’ that would mean 100 entries!

For whatever reason, by the Sep 3 deadline, only 2 vids were received, including my video. I suggested that Anand extend by another week, to give more time to people to submit. After the extension there were 4 entries total. Hm…. I think a post-mortem is needed to find out why response was so poor. Was it insufficient publicity, or people were intimidated by having to put out a 90 sec vid, or apathy (‘tidak apa’)?

Fast forward three months

The public is now voting enthusiastically for the four video entries each featuring a different cause, all noble ones.  (View Vids HERE)

Putrajaya Night Marathon 2011 Make a Change Promo Video Shoot $6000 Cash Prize

Just a quickie before I get back to work. Anand and Akmal of Hooha Asia interviewed me against the gorgeous backdrop of the Kepong Botanical Gardens during lunch just now. This was for a promo video that will be now up at the Hooha Asia website for the Putrajaya Night Marathon (PJNM). View promo video HERE.

In a nutshell, if you know someone who is in need, and for whom $6000 would make a difference in their life, and you are going run 10 km, 21 km or 42 km at the PJNM, you are eligible to participate in this 'reality' competition where you submit a 90 sec to 2 minute video that states who you are, why your friend should be given that $6000, and what change it will bring to their life. The public will vote on the best video and decide who gets the prize. 

I will be doing this for my bestie, who has to remain anonymous for now. I first met her when I was hospitalised at 24 years of age, for my own mystery illness. She was a patient too. My age. We hit it off. She has lupus (SLE) and I have a more rare autoimmune illness (Henoch Schonlein Purpura). For both, doctors don't know the causes. There is no known cure. In lupus, the body attacks itself, in some victims it is the skin, or kidneys, in others the joints, and for my friend, it is her skin, joints and her brain. Life expectancy ain't great. A few of my friends that I got to know while warded in hospital have already passed away. Too young to die....

Trying to Run Away from Myself

Summary of Post

My first 10 km! Also my first 10K in Vibrams! Also my first 10K with kidneys on strike! Could be a depressing post, don’t know yet. You have been warned!

Gracie's Komodosport Vibram Five Fingers.
Best bday pressie ever! Thanks hubs!

Post Port Dickson Triathlon Sprint – Onward Ho!!! Not…

Right on the back of my first tri (wonderful, perfect, dream tri for this tri virgin hehe), and completing my first 1.5 km open water swim with Cynthia (Olympic Distance phwoaarrrr *happy*), I was on top of the world! Best of all, my kidneys were behaving nicely, and fingers crossed I set my sights on a Half-Ironman at Desaru International Triathlon September 24 & 25. I forked out US$30 for 6 months membership at BeginnerTriathlete.com, for access to their great training plans. I was a member 2 years ago before being sidelined by illness, so I know they are good. I figured if I am not ready for Half-Ironman closer to the registration deadline, I’ll just do the Sprint instead :).

Then, I got Food Poisoning. (Note to self: AVOID Jusco Aeon Sushi King!) Day Two of Food Poisoning, kidneys started to leak protein and blood in trace amounts. Day Three, food poisoning symptoms less, but too late, proteinuria already serious (3+). By that time I already upped my meds – those hated corticosteroids (e.g prednisone, but I use hydrocortisone). Today is Day Five, massive proteinuria. I can just hope it will come back down in the next few days. I don’t want to get any weaker. I can't afford to get any weaker! Please meds, please work!

Anyway, yesterday I managed to complete my Bronze Medallion life saving certification at the Titiwangsa Golf Club. Today my training plan called for a 1 hour easy run. Usually, when I am relapsing like this, I don’t exercise much (re: 'Exercising with illness: Can?'). At the most, I get on my Orbitrac for 10 minutes and just move a bit.

Today was different.

Today I felt really frustrated. I’m sick of being sick. I’m fed up of ‘babying’ this body. So today, I tried a different strategy. I love running. I was desperate to run. So I did.

The Run

Ouch I got a Stitch while Running! WHY?

Summary of Post

I sometimes get a stitch in my side while running and wondered WHY?! I DON'T LIKE! I'm sure everyone here has kena before. Here's what might help.

"The docs like to call it 'Exercise-related Transient Abdominal Pain' (ETAP) because 'side stitch' is too easy" (Pam Perdue)

The Physiology of a Stitch

A stitch is when your diaphragm (a muscle separating your lungs from your guts and organs) SPASMS. A stitch actually feels more like a hunting knife being plunged bloodthirstily into one's side. There's no blood externally, but you gotta wonder if something awful is going on in there where the sun don't shine. Good news is, nobody seems to have died from a stitch yet.

The diaphragm moves down when you take a breath, and moves up when you exhale. Your guts and organs are attached to the diaphragm. When I am running, it's all a big jostling mess inside, even though on the outside I look quite cool ahem. The Liver – a heavyweight hitched to the right side of the diaphragm – is what you can blame for the Right Side Stitch, the side most runners get it. As you breathe out, your diaphragm moves up, but those pesky guts (what are they good for anyway) pull down on it. Even worse if you are The Type (like me) that breathes out while the right foot hits the ground. I received enlightenment today that my breathing actually synchronizes with my stride, that is, I always exhale on the same right leg. It's amazing what nuggets of wisdom pick-up-able from surfing the World Wide Web.

Formula for Right Side Stitch = Exhale while landing on right foot = Diaphragm moves up + Liver on right side of body moves down = Right Side Stitch.

Un-Stitch Me!

I found these tips from J. Johnson extremely useful:

1. Belly breathe instead of taking shallow breaths. So the diaphragm lowers right down and the ligaments (that attach your guts to the diaphragm) can relax.
2. Switch up your 'footedness' and exhale as the left foot hits the ground instead of favoring the right foot. Give chance to the left foot la. There are less weighty guts stuck to the diaphragm on the left side.
3. Don’t run on a full tummy. Heavy stomach from that large super supreme pizza, nasi lemak and char koay teow equals more strain on your diaphragm. 

Here's to stitch-free running y'all! Please feel free to leave a comment and/or additional tips on preventing stitches at the end of this post. Peace!