Heel pain, plantar faciitis

[barefootn]

Help! Three months until Boston Marathon.
I started developing heel pain, like a bruise or sharp pain towards the front medial part of the heel bone on my left foot this past summer. I was able to continue running without problem and the discomfort would go away after a few minutes. My running is ninety percent barefoot on asphalt. Last November, after a long run wearing shoes, the plantar fascia was quite sore (worse the day after the run). It hurt when first getting out of bed. I sent for the Strassburg Sock. The sock definitely helps, as I have not had the morning pain since. I did have to put the sock on while wearing a flip flop, because it was pulling my toes up causing pain. I took off a week and then gradually resumed running. I still have pain in the heel and the fascia, however by running only three miles every other day and ten to eleven miles on the weekend It seems to be manageable. I am very concerned that as I increase my long runs to eighteen or twenty miles my foot will not hold up. My treatments consist of frequent deep massage by hand and by rolling my foot over a pool ball. I also do mild stretching of the calf. I do use the stick to look for trigger points or tight spots on the calf and upper leg muscles. I am sure a couple of months without running would cure this, however, I really do want to run this marathon and at seventy years old I am not sure how many more I can do.
I would very much appreciate any ideas as to how to treat this injury and how to continue training.
Thanks so much

 

[Dr Emily Splichal]

Hello - it does sound like you are experiencing plantar fasciitis. You are taking the appropriate steps to manage the stress you are placing on the soft tissue but would I would include would be:

1. Foot strengthening exercises such as short foot (you can find good youtube vidoes on this)
2. Eccentric exercises for the lower leg = such as walking backward on a treadmill, negative heel rises, negative steps - this teaches the body to more efficiently decelerate
3. Core strengthening or activation before you run - this could include planks, isometric crunches, glute bridges.

I look at plantar fasciitis as an impact-related injury or inefficiency in deceleration. We decelerate through our intrinsic foot muscles contracting, eccentric contractions into the myofascia and core stability.

This should help as you begin to increase your mileage!