Friday, January 7, 2011

Plantar Fasciitis Improvement (At Last)

Although I've been quite active with my blogging of late, I haven't really said anything about my plantar fasciitis. A few weeks before 2010 came to an end, I decided to shut down from running for the rest of the year and go into silence because, quite honestly, writing and talking about my foot injury was causing me a great deal of stress. Alas, despite my every effort, I just didn't feel I was getting anywhere.

Things have changed. A little.

I'm continuing with my physical therapy and, while my foot still isn't "right" and I still feel pain especially at the end of the day, Rob (my physical therapist and an Ironman triathlete) and I both agree that healing is under way. There's not any "knotty" tissue in the foot--a very good sign--and my foot is looser, but there's still dull pain in my heel. My arch is fine.

Amid all the physical therapy, I decided to order some orthotics (through my foot specialist, Dr. Ng) specially designed for long-distance runners. They are, quite appropriately, called the Marathotic. My orthotics, for which I'm having to shell out a whopping $375, will arrive any day now. I'll need to break them in over a period of weeks, spending more and more time in them everyday until my feet finally accept and adjust to the added support. Am I happy about having orthotics? No!

Why no? Because, as both my physical therapist and foot doctor have noticed, I have very neutral feet. In other words, my feet don't have any mechanical problems and are actually "made" to run long distances. This bout of plantar fasciitis, then, isn't really from overuse or a mechanical problem--it is from acute damage to the foot. An injury. I have my theories, and they start and end with multiple treadmill runs at 13% at hard pace to train for the Leadville 100. These were second runs of the day, and so when I stepped on the treadmill and ratcheted up the incline I was already tired and in recovery mode from double-digit miles run earlier in the day. Do lots of 13% hard runs at 6,000+ feet and at the end of a 100+ mile week and problems may ensue. My foot is Exhibit A.

So the orthotics are, in my view, temporary. I'll wear them for as long as I need and then transition out of them. They're on the way and, happily, I've restarted my running but very conservatively. I started gradually, running for just 10 minutes on day one. I've increased my time conservatively and am now at 40 minutes on the treadmill. I'm running slow (about 7:45-8:00 pace) and with zero incline, while focusing on my form. Midfoot strike, arms swinging efficiently, leaning forward ever so slightly--this is form-sharpening time. My foot needs it.

I'm also hammering away on the cycle. I hated the cycle at first but love it now. I go hard....and then harder. My legs have changed from the cycling, getting a lot more muscular. Time will tell if that's a a good or bad thing as far as running.

Right now, the goal week in and week out is to work out for 9+ hours and start adding onto that once I have a solid base back in place. Nine hours is about how long it would take me to run 70 miles a week--which is what I usually run this time of year. I'll continue to increase time on my feet running while decreasing cycling time, but I'm going to stick with the cycle for good because I believe it's very beneficial. I also want to finally act on my curiosity about yoga. A runner my age (37) has got to change his thinking because pounding out big mileage without cross-training and without enough recovery is only for the young. I read an interview with 37-year-old Chris McCormack, two-time winner of the Ironman Triathlon in Kona (including the 2010 race), in which he recommends yoga for older athletes. He says it's critical.

When my orthotics arrive, I'll finally have the support my foot needs to completely heal. My goal is to be knocking off the mileage and totally in Leadville Marathon/Leadville 100 training mode by April 1. Cross-training will continue to be part of the mix, but so will weeks of 90+ miles of running. Recovery, too. So important.

My lesson from all of this: It's important to get control of injuries early. If only I'd seen a doctor back in July or August, I'd probably be fine by now. Secondly, cross-training and recovery have to be a part of my training.


During these difficult several months in which I've battled injury, "Back in the High Life Again" by Steve Winwood has been inspiring. A semi-cheesy video...yes. But a classic tune no less. Steve Winwood gets too little respect.


  1. Glad to hear that stuff is starting to dispel.

  2. excellent cheese.
    Good luck with the recovery

  3. i suffered Plantar's for several years in the past, and as even came back 2 years ago. the 'Sock" really help in recovery, but to be honest it will not go away till you change your running style. i run in Luna sandals now on rough California trails, no problems with feet, knees,or hips. in fact it has helped all these things that i suffered discomfort from. give it a shot, meaning change running style. good luck!

  4. try changing running style. i had Plantar's for years, but now i run in Luna sandals. good luck!

  5. Hi Dirt on My Feet: I've had my style/gait assessed and it's pretty sound. The cause of my PF, based on what my practitioners can see, was acute trauma to the foot--like those hard 13% grade treadmill runs combined with 100+ miles a week. I've worked a lot on my form over the years because it's so important. I'm a midfoot striker and I always run with my knees slightly bent--for shock absorption. I do think my shoes didn't help. During my LT100 training, we were saving money for a house and so I was running in several pairs of shoes with 500-600 miles on each. Usually I replace my shoes around 400-450 miles.