Wednesday, November 10, 2010

It's confirmed: I have plantar fasciitis. Now what?

Yesterday I saw a renowned foot and ankle surgeon, Alan Ng, D.P.M, FACFAS, at Advanced Orthopedics & Sports Medicine Specialists here in Denver. Upon entering the medical office building, I immediately knew I'd come to the right place. This very architecturally impressive building and its design were state-of-the-art, and the same could be said of Dr. Ng's office. He works for a large group practice and I noticed a few other athletes in the waiting room. In my mind, these were all good signs. As an added bonus, I didn't have to wait long!

Upon arriving, I was x-rayed, and then shortly thereafter Dr. Ng looked at the radiographs, examined my foot and made the plantar fasciitis diagnosis. Plantar fasciitis is basically the fraying and inflammation of the fascia running across the bottom of your foot and connecting your heel bone to your toes. It's a rather common injury in runners, women who are pregnant and people who are over-weight.

How did this happen? I've had a few bouts of plantar before but was always successful in managing the injury with ice therapy, stretching and strengthening exercises. With this recent bout, starting in July, I thought I could successfully manage it myself (as I have in the past) but ultimately had no such luck. I think with the long climbs out here in Colorado and all the extra stress put on my body as a result of running at altitude (especially those 100-mile weeks preparing for the Leadville 100), the plantar fasciitis got worse and worse. Finally, in early August, I realized I had to rest during the three weeks before the Leadville 100 or else there was no way I could finish the race. Well, I finished the race and I think the pre-race rest was crucial, but it wasn't enough to heal my foot. I know this because my plantar fasciitis came back with a vengeance when I started running again after Leadville. Through it all, I stupidly didn't see a doctor.

After examining my foot, Dr. Ng recommended a cortisone shot, some stretches and a splint to wear at night. The cortisone, he said, would take care of the inflammation and promote healing. I was a little leery of receiving a cortisone shot because in some cases it can actually weaken ligaments and tendons to the point that they rupture. And while Dr. Ng acknowledged this risk, he also told me that the chances of a plantar fascia rupture were rather remote. So I got the shot! And damn did it hurt!

I am allowed to start light running tomorrow (Thursday) and need to keep my mileage rather conservative for the foreseeable future. That's fine with me. We're moving into our house on November 22 and so between now and then I'm going to be busy and scaling back my mileage will be OK. In my mind, I'd like to start dialing it up on December 1, especially if I'm going to run a spring marathon.

So last night I wore my splint, which is an equally critical part of the healing process. The splint holds the plantar fascia and Achilles tendon in a lengthened position overnight so that they can be stretched more effectively--an important part of the healing process. Before getting out of bed, it's important that I do some stretches using a towel. Keeping the Achilles and calves stretched are vital to healing.

So at least now I have a treatment plan under way and can feel confident that my foot is actually healing. And if healing doesn't come as expected, Dr. Ng will fit me for a special runner's orthotic, but hopefully there will be no need for that. I told Dr. Ng I've run close to 25,000 miles in the last seven years and that my feet have always held up pretty well until now.

Now for the call to action! If you are experiencing heel and foot pain, see a foot specialist immediately. Don't delay like I did for nearly five months. I made a huge mistake in assuming I could manage my plantar fasciitis, and now I can only wonder what my Leadville 100 time might have been (a few hours faster? We'll never know!) had I gotten treatment on the front end. I also might have been able to do a fall marathon had I gotten treatment sooner. I've suffered for close to five months and this didn't need to happen. Lesson learned. Tackle the problem now by seeing a specialist!

1 comment:

  1. I am pleased you have made the right decision because in the long run it will only pay dividends.

    Half the battle is in your head as I know how much of a challenge it will be to lower the mileage and keep yourself from crawling the walls so it's really good you have a supportive family. That for me is so important when running is going well or not so well.

    Keep positive and you will win this war.