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Old 09-12-2005, 05:57 AM   #1
mike harrison
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I should have referred to the CF message board much sooner. I've been nursing Plantar Fasciitis for some time in its minor form, and it has affected my workouts much off and on.
Now, I've have been down for three weeks after an exercise at work which produced a major plantar fasciitis flare-up. One doctor has described it as a torn ligament attached to the plantar area just if front of the heel.
I’ve had one cortisone shot in the foot two weeks ago, and used ice and stretching as I go.
I could use any practical advice, or your experiences dealing with this. Come on, throw me a bone here. Need relief.
Thanks Mike
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Old 09-12-2005, 06:49 AM   #2
Christian Lemburg
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In addition to the stuff the doc told you, massage your calves - both the gastrocnemius and the soleus, where the crosses are in the pics below (easy to do by pressing your calves against the knee of the other leg with legs crossed when sitting). You will probably find very hard knots there that will hurt like hell when massaged (trigger points). Don't give up, massage with short, slow strokes in one direction for about a minute or so, multiple sessions per day.

http://www.crossfit.com/discus/messages/27/13899.gif http://www.crossfit.com/discus/messages/27/13900.gif

P.S.: In his book "Lore of Running", Timothy Noakes reports that an elite level athlete going through calves massage (Bruce Fordyce, 9-time winner of the 90km Comrades marathon in South Africa, IIRC) called the "cross-frictions" of his calves during massage "crucifixions". While pain is not the goal of this procedure, expect a lot of pain when massaging your calves - as a runner, I can personally testify that trigger points there hurt really bad.
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Old 09-12-2005, 04:54 PM   #3
Jeremy Jones
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PF. . . had it for about 6 months.

Didn't start wearing the night booty thing until about 2 months ago. Get one and wear it, they help.

Stretching is good, propper arch supports and padded shoe inserts help too.

When I know I am going to be using that part of my foot, I will tape it up. Basicallly I run a band of 1" tape around my foot below my toes, then run tape from the top of my foot, inbetween my toes, along the bottom of my foot and up my heel to where my achillies tendon starts. I usually end up with at least 3 or 4 strips. I put another strip around the base of my toes to hold the tape in place, and one perpendicular to the strips around my heel to hold them in place.

The first strip under the toes is there to minimize the 'cutting' of your toe webbing by the tape. The set up always feels tight for me at first, but then loosens after an hour or two - it probably keeps working for about 4 hours. After 8 hours or so it might as well not be there


I have also been sticking my foot in a bucket of ice near nightly. I try to leave it in there for at least 30 minutes based on a cryotherapy article in the July Performance Menu.

Basically it is important to keep maximal cold on at least 6" or more past the area affected. This means I have the ice water up to my ankle and sometimes I allow my toes to stick out.

Before I was just resting my foot on a gel pack thinking that was doing something. I really didn't see much progress until the Ice submerge baths, and the booty thing.


And yes, it brings a whole new meaning to the term 'sexy booty'


On a side note, even without running, I was able to tighten up my zone dieting and drop about 15 - 20lbs of weight with no strength loss. Just modified CF WODs.


It is getting better slowly. It got worse before it got better for me. I have gotten away with doing the WOD without running, box jumps, or jumping rope for the last 6 months or so.
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Old 09-12-2005, 04:59 PM   #4
mike harrison
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Thanks Christian,
I'll put it to use. Suspect I spend too much time sitting in a patrol car, and not enough time stretching and massaging. Thing has really plowed me under.
Since the post I've loaded PLANTAR FASCIITIS into the CrossFit Google engine and located more than I could read in an hour. Thanks CF family, tons of great information out there.
mh out.
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Old 09-13-2005, 03:28 PM   #5
Andrew Trueblood
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I'm speaking generally here, but this is an approach to treating plantar fasciitis that has a long track record, gets good results, and is generally accepted by the orthopaedic community. At least, it's the way that I've learned to take care of the problem. This is meant for educational purposes and not as a prescription for treatment. Nothing in the world can substitute for a physical exam, so if something hurts and it worries you, get someone to look at it.

Plantar fasciitis is inflammation of the connective tissue sheet on the bottom of the foot. This fascia is a sort of natural arch support and can get irritable with chronic stretching, i.e. stressing the arch or developing flat feet. Generally pain from plantar fasciitis localizes to a spot just distal to the ball of the heel, is exacerbated by passively extending the great toe, and peaks both in the morning (start-up pain) and in the evening when trying to go to bed. When it's bad, it can really interfere with activities during the day, too.

Treatment of plantar fasciitis takes a four-prong approach. First, procure a night-splint from a medical supply company. The purpose of this device is to prevent morning start-up pain by keeping your ankle out of plantarflexion while you sleep, keeping the arch stretched. Plantarflexing the ankle relaxes the plantar fascia, releiving tension on these inflamed tissues. Unfortunately, when you stand up on the thing in the morning, you tear up all of your body's attempts to repair itself that went on over night. That hurts. Sleeping with the ankle up to at least neutral keeps the plantar fascia stretched and lets it heal in a position of function. Heal it where you're using it. Alternatively, you can just wear a ski boot to bed if you have one already. But you have to be patient. Wear the splint every night, all night for at least a month or two and most people notice significant improvements in their morning symptoms. The start up pain is usually the first thing to go away and this effect is a sort of incentive to keep on with the other stuff.

Second prong, support the arch while walking. Get a pair of cushioned orthotics with an arch support. This protects the plantar fascia by physically decreasing the amount of stretching to which it is exposed.

Third, physical therapy to strengthen the muscles that support the arch and stretch your Achilles tendon. To some extent, you can do most of this at home. Try runners stretches with a folded wash cloth under the ball of your big toe. The cloth supinates your foot slightly, keeping you from stretching through the foot instead of the ankle. Strengthen your arch supporting muscles by supinating and pronating your foot with a light theraband around your toes for resistance. Or if you want more direction/instruction, etc. talk to your primary doc for a PT referal, emphasize Achilles stretching, 1st ray plantarflexion, hindfoot inversion/eversion stretching/ strengthening, with local modalities prn.

Finally, over-the-counter anti-inflammatories can take the edge off of your pain while you wait for the night splints, exercises, and arch supports to take effect. Obviously, stick to the over-the-counter dosing always and stay with Tylenol if you have any history of ulcers or gastrointestinal bleeding.

In summary, there are no lasting, overnight miracles. It takes steady effort to get rid of plantar fasciitis. A good rule of thumb is that it takes as long to get rid of fasciitis as you've had it. Be patient. Surgery is rarely the answer, and then only in refractory cases. Some might also stay away from cortisone injections because of the nasty habit they have of weakening connective tissue locally and because, really, it doesn't treat the problem, just the symptom.

Just my $0.02.
Good luck.
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Old 09-14-2005, 03:57 PM   #6
Kevin Okerlund
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Ice, Stretching and the night splint. Real relief came to me when I started using the night splint.
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Old 09-17-2005, 09:58 PM   #7
mike harrison
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I really appreciate the advice from all of you. Maybe a little light at the end of the tunnel.
Lightly working it out, stretching, ice and massage has brought a good amount of relief. The road seems to be a long one though.
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