Thursday, June 18, 2009
The last time I hung up a number was July 4, 2006. It was following that race that my injuries really took off and, since then, my running life has been centered on injury diagnosis, doctors, MRIs, physical therapy, grumpiness and about 15 extra pounds.
Yesterday, for the first time in 3 years, I ran 3 miles and my feet handled it really well. The timing couldn't be better. In the next couple of days I'll go register for our town's July 4, 2009 5K. I won't care (at all) about my time. In fact, I'll probably not even bring my watch. Being able to run it will be good enough for me.
Now I've gotta find my staple gun......................
Monday, June 1, 2009
The Plantar Fascia is a set of connective tissue on the bottom of the foot that ties together many of the bones in the foot. The term Plantar Fasciitis (PF) gets its name from inflammation and micro-tears that occur when the Plantar Fascia is over-stressed. Additionally, the attach point at the heel bone comes under stress, leading to pain in the middle of the heel. Many websites can be found detailing PF symptoms and suggested treatment. Here is a good one.
Apparently (based on my reading as well as personal experience) one key reason that Plantar Fasciitis develops is because the natural process of pronation (your foot rolling inward when the heel strikes the ground) is too abrupt, rather than it being a controlled movement. Uncontrolled pronation ends up transmitting too much force and rough treatment to the Plantar Fascia - something it was not designed to handle. Controlled pronation is more easily tolerated by the Plantar Fascia than uncontrolled pronation.
So, what can be done to help control pronation?
- Arch support. Control pronation from underneath the foot. Help stop if from moving too much. There are two schools of thought in podiatry today on how best to provide this support: rigid or flexible orthotics. I believe in flexible, which will become evident through the rest of this article.
- Intrinsic Foot Muscles (IFM). These are muscles in the foot. Two classic exercises for strengthening the IFM are towel curls and marble pickups. Additionally, however, I found this fantastic article that describes another foot exercise. It specficially addresses strengthening the IFM to better assist when the foot is pronating. Check out pg. 6 of the article found here.
- Posterior Tibialis. This muscle runs along the inside of the shin bone. The tendon runs around and underneath the inside of the ankle bone and connects to both the top and bottom of the foot. This muscle helps slow down (control) foot pronation. Ozzie Gontang has written a great description for massaging this muscle. (Look at the bottom of the page.) Here is a YouTube video on how to strengthen it.
- Gluteus Maximus. Huh? Gluteus Maximus (GM) helping with pronation? Well, it turns out a weak GM allows the femur to rotate too far inward, which means the knee is too far inward, which means there is no way for the rest of the chain (Posterior Tibialis, IFM, etc.) to deal with all that pronation force. If you sit a lot during the day you're especially prone to weak or inactive GM muscles. Here are some ways to strengthen Gluteus Maximus.
And don't forget: The traditional PF treatment, in my opinion, must also be followed. Stretch the calves. Ice the Plantar Fascia. Etc.
My podiatrist says that, when everything is all calmed down and the feet are accustomed to a given level of activity (which can be a multi-month process), then one can "wean" themselves off of the major arch support inserts that may have been used to get through PF. He is a big proponent of the Superfeet Green inserts. Hopefully, given time, that will be the only arch support required.
So........treat where the pain is - the foot itself. Traditional PF treatment is needed. (Even when the car needs alignment the irregularly-worn tire still needs to be replaced.) But don't lose sight of how the other parts of our "suspension" also affect Plantar Fasciitis.