Plantar Fasciitis


Experience From - Milt Scholl , Dave Cooper , Jay Hodde #1, Karl King #1, Rob Grant , Norm Yarger , John Vonhof , Tim Jantz #1, Paul , Karl King #2, Barry Fisher , Tim Jantz #2, Jim O'Neil , Jay Hodde #2, Rob Youngren , Shawn McDonald #1, Jay Hodde #3, Unknown , Sarah Tynes , Fred Liebes , Karl King #3, Larry Robbins , Shawn McDonald #2, Tom Noll , Raymond Goure ,

Milt Scholl

Andy Holak wrote:

"I've had similar foot pain, that I believe to be plantar fasciitis. For the past three months or so, maybe longer, I've had a pain in the arch area of my foot, between the heel and big toe. From what I've read, this is plantar fasciitis.

The interesting thing is, it rarely hurts when I run. Before the ST50 in September, my arch was pretty sore, and I thought it would bother during the race, but it didn't at all. Maybe because all of the other aches and pains were worse! ;-) Anyway, I feel the pain most readily at night when I get up at 3:00 am to go to the bathroom. I limp all the way there, ouch, ouch, ouch! Also, I haven't been running regularly lately, and it seems like my foot hurts more on days that I don't run, than on days that I do run. I assume that the activity keeps the tendon or whatever stretched and loose. When Blake states that stretching helps, I really believe that this is true. Hopefully, it will remain just a nuisance."

Boy does this sound familiar!, with the pain of recognition literally. I've had something similar on the bottom of my foot where you would expect plantar fasciitis - however it wasn't that. It was spasam of muscles in the foot which took a shot of long acting anesthetic to quell, and 48 hours later no pain.

The night/morning pain I have fought through too. My doctor felt it was adhesion of the fascia on the tendon - very painful to touch so massage was difficult. But running was not painful and was helpful. His suggestion, which worked, was to wait it out but handle it very gingerly before it loosened up - to the extent of NEVER walking barefoot, even in the shower, always having some form of arch support. And before even attempting to put weight on it, rotate and stretch your foot muscles and ligaments for at least a few minutes.

It went away after several months but never restricted my running.

Dave Cooper

I have suffered from PF for almost 2 years and as several have pointed out it rarely bothers me while running. Blake was right on the many with the stretching and ice but I would like to elaborate if I may. I my mind the most useful stretching is that which is done most often and I hate to stretch however for this malady I have found a very convenient method. First get several tennis balls. Several because you will want one at the office, one in the car, one at home. Now anytime you are sitting down roll the ball back and forth under your arch. I am doing this as we speak and do so all the time I am at home on the computer. For most people this would amount to several hours a day of stretching as opposed to 5 mins. You might want to ware clean socks to work though. In addition to streaming the bottom of the foot it is also helpful to stretch the calves. As for iceing I find that a small frozen juice can rolled under the foot after every run to be helpful. You might want to leave your socks on for this one. Blake also mentioned never going barefoot. In that vain I will point out the single most helpful solution to my PF. Full length arch cushion inserts. Put these in every pair of shoes you own(Blake...even your slippers). Do not use Heel cushions as this will aggravate the problem (at least it did in my case ). This problem is often mistaken for heel spurs( and it can lead to them). Finally I should point out that this is not a problem that will go away with a few weeks of attention. I have had mine for nearly 2 years. It does not bother me much anymore but I can tell it is still there. Blake mentioned 10 years for his. Be patient with this....It is going to be around for awhile.

Jay Hodde #1

Dave says:

"There is also a device available that is worn at night. The contraption is designed to keep the foot stretched while sleeping. A friend of mine is using one of these things and claims not to have the extreme pain with the first steps in the morning. I don't know who makes the device or even what it is called. Maybe someone else on the list can help."

I don't know what it is called or who it is made by because we make our own out of orthopedic casting tape.

The theory is really simple, and the night splint seems to help in a number of cases.

When you sleep, the ligaments and tendons in your feet (actually, anywhere) tend to tighten up. The night splint keeps the PF in a stretched position, and prevents the re-injury that occurs when you first step down in the morning. This is one of the reasons that PF is such a chronic problem -- that every morning you re-injure in by doing nothing more than getting out of bed!

A couple of suggestions on dealing with the problem:

  1. A gentle foot massage each morning BEFORE you step out of bed can lessen the risk of re-injury.

  2. Don't walk barefoot. And make sure your shoes have decent arch supports.

  3. A mild anti-inflammatory might help in acute cases.

  4. If you don't have PF now, I would be aware of any arch pain that occurs, and take steps to remedy it right after it occurs. This might necessitate taking a day off from running, changing shoes, or (GASP!) a DNF (which I did at Leadville). If you take care of the problem right away INSTEAD of trying to live with the pain, you will have much better results in the long run.

Karl King #1

Like many runners, I had my dose of PF problems not long after I started running. It was the typical case: pain upon getting out of bed, fading after a few minutes of walking. By luck, the cure came to me - foot massage almost every day. The method was simple: use the thumb to massage across the sole of the foot, and the fist to massage along the sole of the foot. It took only a couple minutes to do each sole. After a few weeks the problem faded away and has not returned. Now I massage about 4-5 times/week.

Icing helped relieve some of the pain when the problem was at its worst. PF is a particular form of tendinitis. Stretching such an injured area is always tricky because it can tear the fibers that are struggling to heal. My experience is that stretching is a good preventative, but massage is better when trying to heal an injured tendon.

If you are unsure how to correctly massage an area, you can go to a professional and pay attention to what they do. Usually you can figure out how to do it on your own after seeing their technique.

Rob Grant

This weekend at the Elk/Beaver noticing a couple of my fellow runners in agony with a foot on a bag of ice, I'll post what finally cured?(I don't like that word) my plantar fasciitis. In desperation I went through the usual gamut of sports medicine therapists, chiropractors and orthotics which only lowered the figures in my bank account. Taping I didn't find practical for day in day out training runs, besides, that tape's expensive and I don't believe anyone's skin can withstand it for long. While browsing the rack of support bandages in a drug store I noticed the Futuro Ankle Brace, $10.95(there's lots of other brands which will probably do the trick), I slipped it on; it seemed to give good support to the arch. After about 3 months of wearing it to run & walk(I slip it over the outside of my sock, otherwise I found it irritated the back of my heel) the pain at the back of my arch was gone. I did try running without it but after a few days I thought I felt a little twinge in the arch so I always just slip one on for a training run. I have run every ultra since Vermont(at about 20 miles the duct tape had bunched up, so off it came, thought it would be useless trying to reapply it on muddy feet so took a chance and ran clean) last year without bandage or tape, so far no pain, but haven't had the courage to tackle a road race yet without the bandage or a few wraps of duct tape around the arch.

Norm Yarger

Regarding Plantar Fasciitis, I had problems with PF due to a high arch. I required adequate support for the arch and a cushion shoe. Because of the high arch my foot is rigid and a motion control shoe will not work for me. I tried a popular brand once and was barely able to walk while running at less than 10 miles per week. I gave the shoes to my son who needed motion control, he loved them, and I went back to my cushioned shoes.

Getting back to the PF, I required an orthotic for several years until I was able to find the right shoe. Now I use an over the counter support in my shoes.

John Vonhof

John Scott wrote:

"I have a friend who has told me that at first they thought they had Plantar Fascitus and it was found that a nodule about the size of a small bean was located in that area... She is having an orthotic made to releive pressure on that spot and has not got it yet perhaps this will be a temporary fix . I have had excellent results with a pad on my othotics for Sesimoitis that I got last year ."
A good alternative for those expensive orthotics is to use Hapad inserts. Hapads are wool inserts made from coiled, spring-like wool fibers. They are warm in the winter and cool in the summer. The great benefit to these inserts is you can pull out fibers where you have pressure. In the mentioned case, she could pull fibers out where the nodule presses on the bottom of the boot.

They make full length insoles, 3/4 length, heel pads, metatarsal pads, scaphoid pads. Their products fit almost every foot problem known.

Their customer service is great. Tell them what your problem is and they can either send you a catalogue or will help you over the phone to determine what insert you need. The inserts run from 5.00 to about 13.00 depending on the insert type and size.

I have had great success with their products. Contact them at Hapad Inc., PO BOX 6, 5301 Enterprise Blvd., Bethel Park, PA 1-800-544-2723.

John Vonhof Author: FIXING YOUR FEET: Preventive Maintenance and Treatments for Foot Problems of Runners, Hikers, and Adventure Racers.

Tim Jantz #1

when geting up in the morning is the bottom of the heel hurt or is it the back? either way plantar fasciitis or achilles tendon here is a list of things to try

  1. if you can tolerate antiinflammatories, take them as directed on the bottle regularly and get a good blood level going. my personal favorite is 2 aleve twice a day.

  2. don't wear flat shoes,ie: deck shoes, keds. stick to running shoes, if need be put a 1/8 to 1/4 inch heel lift in dress shoes if need be. if you wear orthotics for running only wear them as much as possible, if you don't have any and have any faults,ie: overpronation, flat feet or high arched feet- look into getting some it will help resolve the problem.

  3. stretch. do the typical runners stretch for the calf. back leg with the heel on thew ground, knee locked and ease foreward. just enough to feel a stretch not burn or pain. then after 1-1 1/2 minutes bend the knee and stretch for another 1-1 1/2 minutes.(this stretch gets both muscles that make the calf muscle the gastroc and the soleus) hamstring stretching is also very important.

  4. get a night splint and wear it faithfully. a night splint is a brace that keeps the foot dorsiflexed 0-5 degrees while you sleep, instead of plantarflexing and allowing the plantar fascia or achilles tendon to contract(you may have to get this at either a physical therapy facility or podiatrist or orthopedic surgeons office) it may be uncomfortable to wear but get used to it, it will be worth it!

  5. if doing these things doesn't get you on the right track, see a podiatrist or orthopedic md who has a good reputation with local runners. you may need to have some ultrasound treatments &/or iontophoresis treatment(steroid medication that is driven through the skin by electrical current (sounds worse than it is, it's painless))


"My friend Bruce is currently unable to run due to heel pain. His email to me describing his problem is below. Does anyone have any suggestions on how to help? "
Deja vu all over again. I tried to ignore the exact same symptoms. The joker in this deck is that the pain subsides after a short run. Obsessed with preparing for a marathon, I refused to take the pain seriously until a tendon tore in the middle of a long run, crippling me for 9 months.

Here's an old post with my recommendations:

NO RUNNING till pain has 90% subsided. This could be MONTHS. Walk, walk, walk. Cross train to avoid weight gain. Have a SPECIFIC program with SPECIFIC goals. Do heel lifts every 2nd day. Stand on one bare foot and SLOWLY rise up on your toes. Do as many as you can. NEVER stand on a stair and let the heel fall below the stair. This is suicide. Get rid of soft inserts. They let the heel sink too far and stretch the tendon. Wear heel inserts to lift the heel and take pull off the tendons Have heel inserts in ALL shoes. NEVER walk barefoot, even out of bed.

No stretching while pain persists All stretching is GENTLE. Icing every night for 10-15 minutes Icing and Ibuprofen after a long run to reduce swelling, but not on a daily basis. Ibuprofen is a dangerous drug if overtaken. See a foot doctor. Wear orthotics if prescribed. Wear a night splint that immobilizes the ankle at 90 degrees while you sleep, and keeps the foot from toe-pointing.

No hill running.

When running, avoid long steps. Concentrate on short, fast-turnover steps. If heel begins to markedly hurt while running, STOP. Your calf and/or hamstrings are tightening and pulling on the tendon. Continuing may cause renewed damage. Walk it off.

Most important: PAIN=NO GAIN.

Karl King #2

Jim O'Neil writes about his experiences with this problem.

It popped up when I started running seriously and it got to the point where it was really cutting into my training and enjoyment of running. NSAIDS took away the pain but didn't solve the problem. Stretching seemed to help at times but made it worse at other times, and didn't provide any significant progress in healing.

What worked for me was to massage the bottom of my foot, using thumbs and knuckles of my fist. I worked across the tissues to loosen them and warm them up, then stroked from the metatarsals toward the heel. The point was to loosen and lengthen the tight bands of tissue that were being stressed with each step. Since there was some scar tissue at the front of the heel bone, I got a professional massage therapist to work on that area a couple times. Ouch! it hurt like hell, but was effective. Now I do the self-massage 4-5 times per week and have not had any PF symptoms since. It costs nothing except the 2-3 minutes time.

Barry Fisher

Zoie Ensslen wrote:

"On another issue - does anyone have some helpful advice for someone suffering (wimp that I am) with plantar facisitis? As normal, my first few steps are pretty painful, but, something I haven't heard anyone mention, after running about twenty miles I begin to feel as though I'm running on broken glass. Any help/criticism gratefully accepted."
Zoie, I had the same exerience and lost a year of running trying several cures for plantar fasciitis on both feet (or should I say "under" both feet?). Had new orthotics from an excellent podiatrist, bought two pairs of new shoes, lots of icing, lots of heating, lots of ibuprofen, special socks, taping and wraps, etc. What finally did it for me (and relatively quickly once I started using it) was a "night boot" my podiatrist recommended.

Nowadays (that was over a year ago that I was cured), at the slightest inkling of any foot pain, I wear the boot and by the next morning, it's much better. Of course, other runners may have tried this and found it worthless, but at least it worked in my experiment of one! It's nowhere near as uncomfortable as it sounds. And there's always the novelty value - as my wife said, she'd never done it before with someone wearing one boot in bed!

I got my boot through my podiatrist (ultrarunner, Dave Hannaford), but if you want to try direct, it's called the "Dorsiwedge Night Splint" from:

Walkwell International
220 W. Jefferson
Boise, Idaho 83702
Phone # 800-786-6562

I can't remember the cost, but it was worth ten times that much to me to get over the fasciitis.

Tim Jantz #2

As a podiatrist, and only a marathoner(hopefully ultra at ice age) I frequently dispense night splints with fantastic success. another source is:

AliMed Rehab Products
297 High Street
Dedham, MA 02026-9135

Ask for the nite splint 2, it is adjustable.

Jim O'Neil

Vicky wrote:

"Have done long enough run in this support to tell if you will have any blister problems? I have trouble kicking myself in the ankles and my chiropractor showed me how to tape my feet for a straighter stride. But, if I do it the least bit wrong I can cause a blister to start. Other problem is that it takes so long to prepare my feet. Only idea I've come up with is to just tape the inside ankles to keep from bleeding but I'm sure I'd still bruise myself."
Vicky, I guess I neglected to mention that I wear the support over my sock, so it is not against my skin and doesn't cause blisters. I guess that's important, I should have mentioned it. I have been wearing it for almost a month for lots of short runs and 1X19 and 2 X26 mile runs and no problems whatsoever. I have it on now and looking at it, it appears that it would protect the ankle against kicking...."after wrapping the ankle, I fold the top down over the wrapping. This helps keep the strap clean and sort of acts like a gaiter." also adds more padding around the ankle, which might help alleviate your problem. I have a size "large" and at first glance it looks a little big if it were to be worn the way it is designed, but since I fold the top down over the strap, the larger size has worked great. Good luck, if you try it let me know how it works for you.

Jay Hodde #2

In my web meanderings, I ran across one of the most comprehensive sites I have ever seen relating to Plantar Fasciitis and Heel Spurs. Since this is a hot topic, I thought I'd pass along the resource.

In scanning the material, it generally looks quite accurate -- a non-doctor gleening information from numerous sources -- he does a good job.

Rob Youngren

I think Plantar Fasciatus, for some, just comes with the territory. I've been running for over 8 years now, ultrarunning for the past 4, and have had PF off and on since I ran my first 100 miler 3 years ago. I think it has to do with putting your feet through a great deal of abuse in an irregular way, i.e. rapidily increasing mileage, or rapidily increasing how far you run (running 100 miles vs. normal training mileage), laying off and then trying to get back into shape by running a lot etc... etc.... I'm guilty of all of this, but I've also tried a great number of things to "cure" this PF. Nothing has worked 100%, but I've learned a few things:

  1. You can train through PF. I've run some of my best races 5km - 100miles with PF, often when it was really painful.

  2. The only cure is to support your arches all the time. The problem is that your arches are collapsing and as they are they're pulling against the attachment point in your heel = pain! I now do not go anywhere w/o arch support. A product called PowerSteps are quite excellent and I highly recommend them, they are a very strong yet thin insole to replace your normal foam insert in your shoe. I bought several (at $24 each not bad!) because I got tired of rotating them through all my shoes. The life span is pretty good, they'll wear out quicker if your running on rough terrain where you are flexing the heck out of your shoes. I also have a pair of Birkenstocks to wear around leasurely, the cork insole molds to the shape of your foot and is an excellent support.

  3. The pain usually is worst at the start of a run, but dimminishes to vanishes as I go on.

  4. A more supportive shoe is a help, flimsy racing flats or trainers will only agravate your PF.

  5. Ibuprofin seems to help, especially during and after a long run.

Anyways good luck, but based on experience I think PF here to stay with me! But it really isn't so bad.

Shawn McDonald #1

I had PF for about a year and a half. I took a few rest periods where I did not run and that did not help the PF. What did help the soreness is to ice it after long or hard runs, wear tape around the heel/arch for support, and to run on softer surfaces. Long term I had to find the structural cause of the injury, which in my case was a combination of tight calf muscles and poor hip (tilted and rotated) alignment. For the lack of flexibility I stretched my calves more and went for several massages over a 3-4 month period. For the hip alignment I went to a chiropractor regularly, and he found out also that my ankles were "locked up" and not rotating freely as they should. That probably goes back to the left ankle that I sprained badly two times, about a year before the PF began.

These treatments over the period of a few months cured the problem, only occasionally do I have any heel pain anymore. I don't wear orthotics. Those help some people with PF, if you overpronate. I also try to not let my shoes go to long before I replace them, to keep my heels and arches cushioned. I also am careful not to run long runs on roads without first doing a few shorter road runs to build up. The roads seem to put more stress on my heels and feet and running on them is more repetitive.

In my case the PF started in the left foot, which is the leg I had sprained my ankle. After a couple of months the right foot developed PF. During the treatments, the right foot improved first and was healed first, then the left one got better.

To summarize, things to try in treating PF:

Jay Hodde #3

Robert wrote:

I think Plantar Fasciatus, for some, just comes with the territory. I've
While I think this is true at some level, I don't think anyone should feel like PF (or most injury for that matter) is JUST a function of the distance.

PF off and on since I ran my first 100 miler 3 years ago. I think it has to do with putting your feet through a great deal of abuse in an irregular way, i.e. rapidily increasing mileage, or rapidily increasing how far you run (running 100 miles vs. normal training mileage), laying off and then trying to get back into shape by running a lot etc... etc.... I'm guilty of all of this, but I've also tried a great number of things to "cure" this PF.
This, in my opinion, is entirely true. When we think of ultra training, too often we focus on increasing our endurance and gaining muscular strength in the quads/hams/legs. We tend to overlook the small, instrinsic muscles of the feet. We also overlook the small muscles in the legs that help us with balance.

These tend to be the areas in which injuries occur.

When we think of training, we often try to do too much too soon. Strength training takes time. . . . and if you look at your long run as an exercise in strength building, you *shouldn't* expect (or TRY) to run a 30-miler in training your first week of ultra training. In the weight room you wouldn't try to bench press 200# if your previous best was only 50#. Likewise, you shouldn't try to run 50 miles if your previous long run was only 5k.

Ignoring the sensible training principle of "gradual progression" is a major causitive factor in many injuries.

You can train through PF. I've run some of my best races 5km - 100miles with PF, often when it was really painful.
Actually, you "can" train through most running injuries. The question is not whether you CAN, it's whether or not you SHOULD. I think that telling people to train through PF is ill-advised. Each case is different and needs to be treated individually.

Why do training injuries persist?? Because too many runners believe they CAN train through the injury and it will go away. It rarely does, especially if the error that caused the injury is not corrected.

The only cure is to support your arches all the time.
My personal opinion is that this leads to weak foot musculature and just makes the injury more likely to recur.

While support is very important, you need to strengthen the structures in the feet -- muscles and tendons. If we, as a human race, weren't so domesticated that shoes have become a necessity for life, we wouldn't the problems with PF that we're having now.

Once PF has occurred, I agree with Robert that arch support is a critical part of the initial treatment. So are foot strengthening exercises.

pair of Birkenstocks to wear around leasurely, the cork insole molds to the shape of your foot and is an excellent support.
Not to comment on Birkenstocks specifically, but sandals generally lack the support that is needed to protect the injured arch from reinjury. Too often runners blame the 45-minutes of running they do for their injury when the real problem is the footwear they choose to wear while standing on concrete floors at work 8 hours a day.

The pain usually is worst at the start of a run, but dimminishes to vanishes as I go on.
This is the typical pattern of pain associated with mild cases of tendon injuries. Just because the pain goes away as you run doesn't mean that damage is not occuring or that the problem has been resolved.

A more supportive shoe is a help, flimsy racing flats or trainers will only agravate your PF.
See the comment on Birkenstocks above. Robert's comment here is excellent. Supportive shoes are a great aid to overcoming PF. The classification the shoe companies use for this type of shoe is "stability trainer".

An arch insole is also a good idea. Spectrum Sports makes a "Graphite Arch Support" that is very good. Implus makes two products, "3/4 Arch Support" and "Full Arch" that are excellent (fit wider shoes better than the Spectrum product).

Ibuprofin seems to help, especially during and after a long run.
IBU masks pain, during and after a run, so it helps you feel better. Its anti-inflammatory role can help limit the swelling that you exagerbated by running long while injured.

In my experience, the single best tip to helping resolve PF: stretch your arches BEFORE standing up in the morning. When you sleep, most people sleep with their toes plantarflexed (pointed). This allows the arch to tighen up while you sleep. If you don't gently stretch the arch out prior to standing on it in the morning, you just aggravate the tissue further, and all the repair that has occurred overnight will be for naught.


Jay wrote:

"in my experience, the single best tip to helping resolve PF: stretch your arches BEFORE standing up in the morning. When you sleep, most people sleep with their toes plantarflexed (pointed). This allows the arch to tighen up while you sleep. If you don't gently stretch the arch out prior to standing on it in the morning, you just aggravate the tissue further, and all the repair that has occurred overnight will be for naught."
Some of my Impala teammates have had terrible cases of plantar fasciitis, even worse than the case that I had, which took six months of no running to resolve. After trying just about everything short of surgery, one who is now a very good triathlete, heard about a boot-like device that is worn at night to keep the foot flexed. She used it and it worked over a period of time to resolve the problem. Others have used it with equally good results.

Sarah Tynes

Road Runner Sports (nfi) carries them. I believe it's called a Night Splint. I've heard great things about them, too.

Fred Liebes

I had Plantar Fasciitis long enough to learn how to spell Plantar Fasciitis . Over a year. I had orthotics before it started. I sort of ignored it for as long as I could, but one day it became a hot, searing pain that stayed around to plague me for months. I then started wearing orthotics in all my shoes, including my bedroom slippers. I taped my foot 24 hours a day, until the skin on my foot started to come off with the tape. (I then developed a method using foam underwrap under the tape). I also backed off on running. The pain stayed with me, especially in the morning. Then I got the Night Splint, as somebody mentioned. This helped alot, but didn't cure it. I got three cortisone shots over a period of six months, the last of which seemed to help. My podiatrist said if I was a professional athlete I would have had the surgery long ago. Humph!

At that point I started stretching alot more, going barefoot at home instead of constant support,and I got some Birkenstocks. I think they helped alot, because they not only have a great arch support, but also you have to scrunch your toes to keep them on, and this continual scrunching is a specific exercise for strengthening the bottom of the foot.

I also did the exercise scrunching the towel with the toes. And did the massage with a tennis ball, a golf ball, and rolling the foot on a frozen water bottle.

All of a sudden the PF is no longer an issue! And I can again run without the big pain. It sort of subsided the same way as it originally started. I'm crossing my fingers (and toes), but I'm hoping that it is true there is an end to this.

Karl King #3

When I got into running longer distances the PF bug got me good - a classic case.

The cause in my case was probably running too much on concrete before my body adapted to the higher workload. Others may have biomechanical or equipment problems as root causes that need to be addressed.

I got rid of the PF and it has not returned. What worked for me: In the early ( acute ) phase, I iced the plantar area before going to bed and put on a sock so my feet would stay warm while I slept ( better circulation ).

I massage the plantar area almost every day. It takes only a couple minutes per foot. The point is to keep the tissues flexible, and promote circulation in that area. The treatment takes only a short time and costs nothing. It has kept me PF-free for 10 years.

A co-worker [ fitness runner, 4 miles/day on concrete sidewalks ] had a chronic case of PF, complete with scar tissue and some calcification. He went to a professional massage therapist who worked on the scar tissue ( very painful ), and he did the daily massage. It took a couple months, but he finally got rid of his PF.

Larry Robbins

Plantar Fascitis is preventable at least in my experience. I have had the affliction only once. Six months of non-running cured the case.

I want to thank Richard Schick for giving me the solution. I already have personally, but the Ultra Community should know. He gave me a device called Pro Stretch. It is a Semi-Circular device, in which you place the foot.

You stand up in it and the bottom of the foot is stretched, as are the calf muscles along with the ligaments and tendons. I stand up in it, hold on to a steady object with one hand and with the other hand pull the opposite up to my posterior to stretch the hamstring of the leg. The stretch is held for about 2-3 minutes. I repeat the formation with the other side. Very effective. After a short run is best or at least a warm-up.

I suspect I will never have PF again. You may ask Richard of his opinion.

Shawn McDonald #2

I had PF for over a year (not uncommon as it is tough to heal). What helped me is a combination of things, including a massage each 2 weeks, regular (every 2-3 weeks) visits to a chiropractor, and taping the heels and bottom of my foot before long runs. I also iced the heels and bottom of my feet after most of my training runs and all races.

The PF started in the left foot (my weaker leg) and after a few months started also in the right foot. Treatments that address the root cause of the PF are most likely to help and lead to healing. In my case, my calves were very tight and I was "out of alignment" in my hips. The massage and stretching helped with the inflexibility and the chiropractic "adjustments" improved my alignment.

About 2 months of the above treatments brought about healing and I've not had problems with PF since. Many others I know who had PF wear orthotics. I don't. The key now for me is to stretch my calves real well after any run and to not do too many miles on hard surfaces. I would recommend a visit to a sports med doc or chiropractor to look for a possible structural cause to your PF, to take some down time and cross train, and work on flexiblity exercises, and look into the need for orthotics. Later treatments would include cortisone shots (to reduce inflammation in the heel) and as a last resort surgery.

There is a good book by Joe Ellis (a podiatrist here in La Jolla) that you might want to pick up... "Running Injury-Free : How to Prevent, Treat and Recover from Dozens of Painful Problems" by Joe Ellis and Joe Henderson has it for $11.96

Tom Noll

I've been meaning to write about heel pain and plantar faciitis for some time and the recent post presents an opportunity. I have been dealing with heel pain since before Wasatch last summer. I can say that heel pain severely dampened my enthusiasm for running. I stopped running, I biked and I walked, but the pain got worse. I read nearly everything that I could find on the internet and in some medical references about heel pain and plantar faciitis. I talked with another runner here in Boise who is facing the same difficulties. I read through Kevin Sayers UltRunR site about heel pain several times ( Mostly I was frustrated.

The writers in Kevin Sayers UltRunR site covered nearly all remedies. Stretching, don't stretch, reduced activity, increased activity, various medical devices, and no one treatment seemed to work for many. It was obvious that PF called for a personal remedy.

I thought about my bone structure and my shoes. Because the pain was worsening even though I was running less or not at all, I began to think that the pain was only peripherally related to running. I thought about shoes. I have always had trouble getting shoes that fit. The toes seem to be too tight and the arch area seems to be too loose -- the lace holes are nearly all pulled tight. Since the early 1980s I have worn Spenco arch supports in all my shoes to make the shoes fit better. Last spring I switched to a new pair of shoes that I thought fit well enough to remove the arch supports. Sometime later the heel pain started, although it has taken many months for me to understand the possible connections. I corresponded with a friend of mine in the newsgroup and he noted that nearly everyone he knows has been forced to wear orthodics to treat PF. Someone else on the list noted that the shoes I was wearing (which are very popular in the newsgroup) seem to contribute to his PF. I began to think that the sole design on the shoes encourages inward ankle tilt for me and the soles may be too stiff. Eventually my thoughts coalesced. I tried new shoes and I changed the shoes I wear at work. I put the arch supports back in all of my shoes. Within a very short time I was able to run mostly pain-free. The transition has been remarkable.

My understanding of the medical thoughts seems to be that heel pain and PF may be due to a flattening of the foot during the stride. As the heel strikes and the sides and forefoot hit, the foot flattens and the tendons along the bottom of the ach stretch, creating tension at the heel attach point. Repeated stretching may lead to pain and inflammation at the heel attach point. Placing the arch supports back in my shoes may limit the foot flattening, presumably lessening the stretch and limiting the tension at the heel. The heel pain has all but disappeared and my shoes fit better too.

My recommendations are to:

  1. Change shoe types,
  2. Explore the possibility of arch supports
I am not an MD and I cannot say whether this will work for you, but it has changed my life, returned joy to running, and I hope I can continue to run without heel pain.

Raymond Goure

Here is a very good web site for PF from taping to product recommendations to stretching. Enjoy.