Maybe I’m dating myself – but have you seen the movie Sleeper by Woody Allen? Woody Allen’s character is frozen after he dies and is brought back to life many years in the future. The plot involves him trying to deal with all these things he doesn’t understand. A consistent theme is that what was once thought to be harmful is now considered healthy – such as smoking.
I’ve thought of Sleeper frequently as I’ve gone through the process of resolving my various maladies. I once thought I could run only with orthotics. I once thought I needed padding in my shoes to protect myself from this horrifically harmful environment in which I run. And I thought, because of my very flat feet and overpronation, I needed shoes that were incredibly structured and that controlled the motion of my feet. Now I’m running with no orthotics, in shoes that are so thin I can feel a pebble through the sole and, sometimes, with no shoes at all. Who’d have thunk it.
I think I’m in the process of putting Plantar Fasciitis into this Sleeper category. I wish I could remember where – I think it was in some YouTube video – but I saw a doctor call Plantar Fasciitis a “trash bucket” diagnosis. He asserted that all too frequently almost any foot pain was just labeled Plantar Fasciitis. That term may be encouraging people to pursue remedies that aren’t appropriate and, consequently, aren’t effective.
Plantar Fasciitis (strictly speaking) is an inflammation of the Plantar Fascia; hence the ‘itis’ after Fascia. The same holds true for tendonitis – tendon inflammation. We tend to think inflammation is bad, so the treatment for Plantar Fasciitis is focused on reducing that inflammation: Icing, stretching, cortisone, etc. Obviously, with all of these treatments, the goal is to reduce the inflammation in an effort to reduce the pain, and get us back to doing what we want to do.
What portions of the medical community are now thinking, however, is that the inflammation of Plantar Fasciitis goes away relatively quickly; on the order of a few weeks. At that point the Plantar Fascia starts to degenerate. The interesting and unfortunate part is that the pain continues. So to a certain degree not much has significantly changed from a symptom perspective, but what is happening physiologically is very different. This degenerative state is called Plantar Fasciosis. Where “itis” is inflammation, “osis” is degradation. This degradation scenario supports the stories we hear and have experienced ourselves about taking significant amounts of time off, stretching for weeks, icing for weeks, etc. and seeing no improvement. We’re taking steps to reduce inflammation when there may not be any.
The trick, then, when dealing with Plantar Fasciosis is to rebuild the Plantar Fascia. I’m no scientist so I can’t explain all the science, but what appears to be working for me is ASTYM. ASTYM intentionally injures the tissue on a microscopic level to cause the body to initiate a healing response. If the tissue is actively used while it is rebuilding the body will rebuild it the right way – in a way that enables it to be used as we want it to be used. Graston Technique is, in my amateur opinion, a similar concept. I feel that I’m repeating to a certain degree a point I made when I compared the more efficient running forms: While different they have similarities and it comes down to which one sounds best to you. Some swear by ASTYM and others by Graston. They have their advantages and disadvantages – but I’ll leave it to others to fight that battle.
So, since the tissue is supposed to be used, and the tissues are being stressed and asked to do more, they often feel “uncomfortable” following activity. The really difficult mental model to break is to not stop doing the activity! The sensations being felt are a result of tissue being rebuilt – just as our arms would be sore after doing an intense weight training session. No – those “pains” aren’t coming from inflammation. The body is rebuilding. There may be times where too much has been done, and “pain” really is felt. But by and large, use it and keep using it. Movement and stress is good. The body will adapt.
Three weeks ago, when I started ASTYM, I could run 4 minutes out of a 30 min walk. Today I completed my 6th and final ASTYM treatment. The last two times I ran I ran for 12 minutes both times, and tomorrow I’ll do 13 or 14 minutes. It really is bizarre – not having everything feel perfect but continuing to exercise. I wonder what else in our lives we currently accept as truth will be challenged by some “radical” thinking?
P.S.: I’m not suggesting one always “runs through the pain”. I hope I’ve been clear that it’s important to work with a professional. I’m relaying my experiences and what I’ve learned from my PT. Your mileage may vary.