Last month I decided to do a bit of running. Well, the mornings here in Western France were beautiful, and I found a lovely two kilometre route that took me across medieval bridges, over misty rivers, and down green-lined country lanes. I do a lot of yoga (I am a yoga teacher, after all, but felt that I wasn’t getting enough aerobic exercise. I loved swimming but my logic was, running is free. It turned out that it cost me about $200 and about a month of my life that I don’t wish to repeat.
It was the morning after my third run that I discovered a dull pain in my heel and around my instep that gradually got worse throughout the week. I went online and discovered that I had a bad case of something called Plantar Fasciitis. It refers to a tear in the ligament (fascia) that runs from the heel down the length of the foot. I had never heard of it before, but I quickly began to learn all I could because in a few days I could barely walk. It turns out I had not been very smart. I knew I had one leg shorter than the other from a motorcycle accident in my teens, so this combined with including hills in the routine, running partly on asphalt, not warming up, all created a perfect storm to render me largely out of action. Not everyone gets plantar fasciitis from running. A friend of mine got it from being on her feet all day in bad shoes at a charity function. It took her eight months to recover.
The pain was bad first thing in the morning and built up during the day with use, so that it became difficult to sleep. It was the kind of pain that saps your energy and adds a layer of grumpiness to all your interactions, and I found myself unusually short-tempered. Pain can do that to a person. I thought it would just clear up with a bit of rest, but I was wrong.
I kept reading about how long this condition can take to resolve. One site I looked at said that ‘most cases resolve between 8 months and a year’. A year?! No, no, no. That was not going to be me.
Over the next four weeks, I threw myself into a therapeutic routine that resulted in a dramatic improvement by the end of the third week, and almost total recovery by the end of week four. And all without a single visit to the doctor. It generally takes a minimum of six weeks and often several months to treat this painful and debilitating condition. I need to preface this by saying that I work from home, don’t have children, and was in a financial position to get a few things on Amazon to help in my recovery. Not everyone is so fortunate. But in the hope that some people might benefit from my experience, here is how I did it.
Four times a day for the first two weeks:
- Ice the heel and sole of the foot with a cup filled with frozen water, for 10 mins each time. I also sometimes used the classic pack of frozen peas. Once into the third week, you may be able to reduce this to twice a day.
- After icing the foot, use the ‘graston’ technique, which is basically working the fascia of the foot with a soft-edged implement. You don’t need to visit a doctor for this, you can do it yourself and don’t let anyone tell you otherwise. I used the back of an ordinary knife from my cutlery drawer. Other people have even used an ordinary metal wrench, so be creative, as long as it has no sharp edges. However, if your hips are not too flexible and it is difficult for you to get into the positions to perform graston on yourself get a friend or family member to do it for you while you lie on your stomach. Graston helps to work and stretch the fascia and increase blood flow to the foot. Focus on the bottom of the foot and the back of the calf. This technique also helps to break down old scar tissue so was very helpful in my case, since the scar tissue around the ankle from my old injury was not helping the blood circulation any. See a demonstration of self-applied graston technique. This kid really has it down and helps to show how to reach the hard to get to areas. Ignore his Jurassic Park tee-shirt and obvious lack of earth years. He’s an old soul and has got the goods. Doing this stuff is boring, but you need to do it for at least 5 minutes each time to get the benefits.By the third week, I was only doing icing and graston twice daily, and by the beginning of the fourth week, I had more or less stopped both entirely since the healing was in such full swing by that point that for the first time in a month I looked forward to going for a walk!
Every day:
- Take glucosamine and chondroitin tablets. I highly recommend ‘Move Free’ by Schiff that costs around $40 for 140 tablets. I’ve also heard that Capra’s CapraFlex works well. Once I started taking these (2 a day with a little food) the pain eased off considerably. Glucosamine is an amino acid that works to repair connective tissue, like the plantar fascia. It also can reduce or even eliminate the need for anti-inflammatory medication such as Ibuprofen since it helps to reduce pain. Interestingly, people who take glucosamine supplements don’t appear to get plantar fasciitis. Here’s a list of some other vitamins/supplements you might want to consider to speed up your healing.
Every night:
- A painkiller. Before the glucosamine/chondroitin arrived (I ordered it online) I did use a pain cream called Voltarol Pain-eze that worked pretty well. The use of painkillers will obviously depend on one’s own pain thresholds and sensitivities. Doctors will most likely prescribe you industrial strength Ibuprofen for this condition, but you shouldn’t really need it, especially once you begin taking the glucosamine, and your liver certainly doesn’t!
- Use a night splint. At night, the foot tends to point, and so it shortens the fascia, so the purpose of the heel splint is to stretch the plantar fascia ligament while you sleep.I took a man’s tie and wrapped it around my foot so that the heel was a little scrunched and it was difficult to point the toes. It looked kind of cool, like a warm up for Kinbaku. If you’re not good at knots, you can also use a special tape for this or even better, order a proper heel splint. I stopped using my homemade heel splint after the end of the second week, since the recovery was well underway. Studies suggest that heel splints do promote faster resolution of this condition, but you can judge for yourself whether you think it’s helping or not.
Essential:
Get some orthotic insoles. You will want to kiss yourself when they arrive for being so in touch with your self-care! You can find them easily online or at your local pharmacy. The best kind are quite firm and conforming, giving a little heel cushioning, and you can slip them into your shoes and even wear them with heeled sandals. Take your time to look at the customer reviews before you order. Not all insoles are created equal.
Optional:
- Dry cupping. Since I had a lot of old scar tissue that was getting in the way of healing, I ordered a dry cupping set. Cupping has been used in China and in many Muslim countries (where it is called ‘hijama’ and apparently was recommended by the prophet Muhammad) I had a lot of fun using it around my ankle. It is not easy to cup in this part of the body though, and almost impossible to get enough grip on the heel itself, so I wouldn’t bother unless you just really like messing around with ancient healing techniques like me.
Important tips:
- Don’t go barefoot or wear completely flat shoes. If you’re a woman (or a man with flair) you can get a lot of relief from wearing some block heeled shoes about two inches high. Clogs might be the best option (not stilettos!) even though they may not look very sexy. Heels elevate the heel and so you can walk with less pain, but avoid shoes with any kind of backstrap. I wore a heeled shoe with a very soft leather back strap one day, and one five minute walk to the shops was enough for me to remove it. I would not have been able to function, especially in the first two weeks without wearing some height under me. Just be careful, especially if, like me, you’re not used to heels. If you got this condition through running, chances are you invested in some running socks along the line, that have supported heel stitching. Wear them, they will feel friendly.
- Don’t exercise. Zip. Nada. I mean it. I went swimming in my first week and it set me back in my recovery. You can do upper body work but not with weights. You don’t want to put any unnecessary strain on your foot. A lot of websites will tell you to do the runner’s stretch against the wall to stretch out your calf muscle. I did this the first couple of days and it made my condition worse since it also stretched the heel! Ouch! Graston is a much safer and more effective way to work the calf muscles when plantar fasciitis is your problem.You can do some simple things like core building exercises (slowly raising and lowering your leg) and remove any stiffness in the ankle and increase blood flow by doing gentle ankle rotations a few times a day, in both directions. Do both ankles, not just the injured foot. You are going to be favouring your good foot when you walk. This is natural, but try to do this as little as possible so you don’t cause an injury to your hip or knee by suddenly putting a lot of extra weight on it. And if this means walking with a stick for a couple of weeks, so be it. Get a cool cane with a dragon head eating the sun or something. Imagine it’s a magic staff. Think Sherlock Holmes or Gandalf!
- Walk as little as possible in the first ten days. Of course, this is hard to avoid. But just really think about each walking trip you do and whether it’s absolutely necessary. Do you have to go to the shops. Can it wait? In the second week begin to walk a little, perhaps to the end of the road and back. In the third week, you can walk ten to fifteen minutes at one time, building it up gradually. You do want to begin to re-engage the injured foot, but you want to be careful not to RE-injure it. Listen to your body.
- Drink lots of water. Water helps to purify the body of toxins, so drink lots of the stuff. Purified water only, and with nothing added to it even though you want to dress it up a bit. Water makes almost everything better. Just do it.
- Avoid inflammatory foods. If you don’t know what this means, find out. It will do you well in the long-run.
- Let people help you. If you’re single you might be like me and used to doing things on your own, so this might be a hard one. But you’ll probably be pleasantly surprised how ready people are to give you a helping hand, whether it’s picking up some shopping for you on their way back from work or cleaning the house. You don’t want to carry heavy items while you’re trying to recover from this, so if you’re a mad feminist like me, it might be time to let that nice gentleman carry your bags for once. Engage your network. After all, they may need YOU one day!
- Understand that it will get better. For some people, depending on how active you are with your therapy and what your own limitations and demands are in your life, it may take longer or even less time to heal. If you work in a job that requires you to be on your feet all day, then it’s essential that you spend a good deal of attention on what you wear on your feet. Be creative and be willing to let go of looking cool over feeling better. Trust me, it will make all the difference!
- Be patient! You may have a few days when you feel things are going backwards. Maybe you overdid it, maybe you strained your heel again. It’s hard to keep aware all the time. Understand that this is a SERIOUS CONDITION. Give yourself the time to heal the heel. It will happen. Trust the process.
Weird and wonderful tips:
I bumped into a neighbour in my small town here in France, who told me about a traditional remedy of cutting an onion in half and sleeping with it in a sock. I began to try this in the fourth week, so I’m not sure I can say if it had any effect, but I’m going to keep doing it. Onions contain the flavonoid quercetin (I know because I looked it up) that acts as an anti-inflammatory in the body, so there may well be something to it. Certainly, I think people were licking their lips and thinking of steak when I walked by them the next day! Will keep you posted on this one.
One final word. Your heel will heal. And yes, you will likely have to get used to a lot of daft foot jokes. Yeah, they’re lame (damn, I did it again!) but you know, you’ve accomplished a real feat (oops!) when you put your best foot forward (sigh). Seriously, you can do this. I did, and I’m lazier than you 😉
La Vie en Yoga 