Originally Posted by Brent Mattis
For about the last 6 months, I've been doing a combination of StrongLifts and some sprints and medium distance training. Mostly injury-free. In September I ran an obstacle race and had very bad Achilles tendinitis in my left ankle. It gradually went away doing heel-drops and stretching, combined with cutting way way back on running.
Flash forward to two weeks ago, really bad pain on the underside of my foot. Suspected it was plantar fasciitis, tried to self-treat with spiky ball massage and some light stretching in the morning. Nada, if anything the pain got worse.
Finally saw a podiatrist today, he confirmed no fractures, no heel spurs, just PF. As always he recommended "more arch support" and custom orthotics. I'm no Christopher McDougall but the idea of using plastic splints to fix my feet seems counter intuitive to me.
I'm a bit worried there is a lot of stuff going on below my waist that could be contributing to the PF. I have very poor ankle dorsiflexion that has resisted all foam rolling, ART, trigger point, stretching, etc. I also have relatively long femurs. So my back squat requires lifting shoes with a pretty hefty amount of lift AND a relatively wide stance. This has resulted in some relatively minor but noticeable hip pain. The shoes have a small gap between the heel and the forefoot and I'm wondering if they have enough flex to exacerbate the PF when I squat heavy.
So far the modalities I've seen recommended for PF are foam rolling legs/calves, tennis/golf/lacrosse ball rolling foot, switching to minimalist shoes to strengthen PF. But otherwise a lot of contradictory stuff.
Any help or support would be appreciated... if this gets worse forget about running, even walking will be too much.
Sorry to hear about your issues, PF is never fun!
Here are a few recommendations:
1) Mobilize your ankle into Dorsiflexion. Without adequate DF you're stressing the Plantar fascia in a way it wasn't meant to be stressed. No Dorsiflexion = excessive pronation when you walk which will only get intensified when you run.
2) Check up the chain and look at your hip extension. Are you stuck with an anteriorly tilted pelvis? Can you actually reach hip extension? Work on your hip extension. Lack of hip extension often translates down the chain into a pronated foot during gait.
3) Focus on correcting movement faults. Poor running mechanics, poor equating mechanics...etc all play a role.
4) I would actually recommend using the orthotics ***TEMPORARILY***. Essentially you need to get the "fire" out, while correcting underlying issues so it doesn't come back.
I also recommend going to see a Quality PT who understands the demands of your training. There is only so much advice I can give without seeing you. The Physio will be able to dial in and figure out the underlying issues, then formulate a plan of action.
Check out my IG feed @groundtooverheadPT I have lots of videos on there targeted at the ankles and the hips. As well as self assessments you can use to monitor your progress in those areas.