Can anyone out there help a complete idiot?
About a month ago I started to develop plantar fasciitis in my right foot - it was a classic heel spur. By way of background I run in Asics 2130s with prescription orthotics that I had removed then reinserted after the PF symptoms started (did I mention that I'm a complete idiot?).
To continue the trend of lunacy, I decided that I'd run through the plantar fasciitis, although I conceded that road running was not a good idea and did my work on a slightly inclined (1%) treadmill. I dropped my pace and mileage too.
About 10 days ago, the outside of my right foot started to hurt badly. A little internet work led me to self-diagnose peroneal tendonitis. It makes sense - the plantar fasciitis on the inside part of the heel caused me to strike on the outside of my foot, leading to the second problem.
I've RICEd it, stretched it, cross-tissue massaged it, cursed it, prayed for it, just about everything but chop my foot off and replace it. Ironically, all the aforementioned rehab has just about cured the heel spur, but the peroneal tendonitis continues to lag and nag. I've got a 5K coming up on Labor Day. Can anyone suggest anything other than "live and learn?"
Ok, now you sound like me....self-diagnosis is great but you might want to consider talking to someone who has a bit more medical school training. Just a thought.
Mine cleared up with acupuncture. It took a couple of months but it worked great!
Susan in CA
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I would definitely recommend seeing a physiotherapist for a proper assessment and treatment. Correct diagnosis is essential to ensure appropriate treatment and the fastest recovery.
Hope that helps and good luck with your recovery,
Susan and Physio Advisor:
You two are, of course, correct. I should get an expert opinion. It's just that it seems like I've run from one injury to another since I started this journey in January of 08 and have had enough medical and physical therapy evaluations to last a lifetime. I expect I'd get a "you again?" look if I went back.
I should say that my plantar fasciitis is 95% better and the peroneal tendonitis is probably 85% better. I actually am walking without a limp this morning for the first time in a couple of weeks.
Maybe the peroneal tendon was just healing on its own, but I found the following old tricks helped me a lot once I started doing the routine regularly:
1. I stopped running. Duh.
2. I started riding the recumbent bike at my gym a lot more.
3. I continued cross-training on an elliptical, my favorite piece of equipment, but cut back the time and intensity on it.
4. I did calf strengthening exercises every other day.
5. I cross tissue massaged the area every day.
6. I iced it every day after my workout.
Hey, this stuff really does work. I hope to get one or two short easy runs in before my 5K on Labor Day.
New Runner, you've chosen a sport that delivers growing pains like no other. I went through the same process, as many of us have.
It's frightening when these symptoms occur, but they are often misdiagnosed. As you have found, they can often be handled by rest and TLC.
You're not an idiot, because you paid attention to the "idiot lights" of your muscles and took action. You were also wise enough to ask for advice from other runners. I'd like to oblige by adding my two cents:
When you transition from life as mortal to Runner, there are muscles on the calf that must work harder and faster than ever. These muscles work in opposition to each other at speeds and time intervals never asked of them before. Even a vigorous basketball or tennis game does not compare. Muscles on the rear and side of the calf get you airborne and propel you forward approximately 3 times per second, and muscles on the front and side of the calf pull the toe up to clear the ground in preparation for the next footstrike. Muscles are firing constantly and there is no rest until you stop. Of couse they're going to experience pain!
Just as you found that rest, ice, and massage work to relax the muscles and control inflammation, your body will gradually adapt to the load you've placed on them. The best runners in the world are doing the same things right now! Who are we to get away with less? It's not a problem, it's the sacifice we make when we decide to run. Nevertheless, there is always something to learn about the body and running is a great introduction. Let me explain a little more:
When you run on an incline, you are asking more from the primary calf muscles (soleus, gastrocnemius). Ditto for any calf-strengthening exercises. You need to move in the opposite direction. Don't make the mistake of beating yourself up to heal, or you will become "muscle-bound." The tougher those muscles become, the more pain you will feel and the more you will ask of opposing muscles to return them to position for the next footstrike. In fact, the pain produced by a wound-up gastroc is felt directly in the arch and is often misdiagnosed as plantar fasciitis!
Massage is good, particularly toward the top medial (inner) side of the rear calf muscle (gastroc), which has solved many a case of faux p/f. Real plantar fasciitis (possibly requiring surgery) would take longer than the time you've spent running. As for the tendonitis, it can be difficult to distinguish inflammation of a tendon sheath from a sore muscle in the same area. I massage my own calves with soap and water every time I take a shower, starting with cold water. I do this proactively and rarely have a problem anymore. If you do this, pay particular attention to the achilles (massage from the side, not straight down or you can rupture the bursa), the entire peroneal area, and of course, deep into a relaxed gastroc and the deeper, lower soleus, penetrating to the underlying toe flexors which extend nearly to the back of the knee. Make sure you support yourself because I don't want you suing me if you slip and fall! This daily ritual will help break up new scar tissue and excess pre-adhesion collagen, and insure the circulation that all healing requires. For me, the cold water forces me to rededicate myself to the sport. It's almost a religious experience...
Lastly, you should perform unassisted stretches near the end of the day while your muscles are still warm. By unassisted I mean in the air using each muscle to stretch the opposing side. When the muscles are relaxed use your fingers to check for tight spots and massage them out before bed. You will begin to recover overnight.
Remember - you chose to become a runner, but if you try too hard you will beat yourself back into mortality, where you'll spend your time watching the rest of us run. The choice is yours.
Thanks! I'll definitely try massaging down the whole calf.
Today is a complete rest day, so the foot feels pretty good. I'm hoping that by following your advice and others I'll be running to my next injury by this time next week.
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