[mdqs]

Hi,

I have running-induced arch discomfort that doesn’t quite conform to descriptions of plantar fasciitis that I’ve come across. Hoping to get help with diagnosis & return to running advice.

I’m not a lifelong runner (25yo M), but I returned to the sport this past summer as I started training for a military pipeline. Admittedly, I hit it too hard: 5x/wk (2 interval workouts, 3 “LSD” runs going way too fast) while changing naturally to a midfoot strike. But for a while I was healthy, getting faster, feeling strong. It caught up with me after 3mo and I started to notice arch discomfort. The discomfort started in the arch of my foot (pictured), primarily in the insole (medial aspect) up to some palpable bone — the head of the talus, maybe? The pain felt something like muscle soreness or an inflammation / overuse injury. It was never debilitating and never sharp, but I stopped running to prevent from exacerbating it.

One week w/ RICE, no fix.
Two weeks w/ RICE, no fix.
I’ve mostly stopped running since ~Thanksgiving 2019. Additional interventions: Voodoo flossing the plantar area regularly. Ice regularly. Mobility work for hips & lower extremities regularly.

Question is: Does this issue sound congruent with plantar fasciitis? If so, do people ever have success overcoming PF by working back into running slowly? In other words, could I run for 1x/wk for 30min, allow a week for recovery, and slowly slowly build in that way? Do inflammation injuries ever respond to strengthening through activity even if it causes temporary re-aggravation of the injury?

Thanks for any input.
John

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[Anonymous]

Anonymous on January 17, 2020 at 1:26 pm #36452

I don’t have the experience to comment, but if you click the blue chat balloon in the lower right-hand corner of screens in this forum, you can connect with our PT.

[Pete Dickinson MS,PT]

Pete Dickinson MS,PT on January 17, 2020 at 7:21 pm #36477

John,
Getting shut down in your running is very frustrating, been there… Mid arch pain can involve a few structures from fascia to muscle. We always like to treat causes to injuries, but sometimes its not your physical imperfections, but your approach to training exceeding the current abilities of your muscles/ligaments/bone/fascia/neural structures (OverEnthusiasmSyndrome). I’m always a big supporter of using coaches for big projects to properly direct your OES. After a rest, return to running is best done with a run/walk progression. Start with 2min run, 1min walk. Seriously, this is where you start!! Progress to 5/1, 10/2, 15/1, then go with 30min blocks. In this way you can let your body adjust to the impacts. Mobility prior to this is essential, I like foot wakers for the arch, and lots of hip rolling. Hip strength helps attenuate the loads at the feet. Progress into single leg strengthening.
Lots to think about!
Cheers,
Pete

[davidmvh78]

davidmvh78 on January 22, 2020 at 10:46 am #36707

Pete is right. Plantar injuries are frustrating and I would add somewhat mysterious. But I do know the longer you let it go the longer it takes to recover. If it hurts when you get out of bed in the morning it might take even longer. I also know that hoping it just goes away on it’s own is a non-starter. So you are right to be asking now.
My advice is yes, you need to lay off and Pete’s recommendations are good. If you are worried about losing aerobic fitness there are other things you can do like biking and rowing. They aren’t the same as running but you can still build a good set of lungs. The actions taken that have helped me include: No more walking around barefoot or in sandals. That spring on the bottom of your foot needs support. I used drugstore supports like Dr. Scholls in all my shoes. Ibuprofen helps for acute pain. It has also been my experience that my calf muscles are beyond tight so foam rolling is good but getting someone to work those things is a great help. Increased mobility of your Achilles tendon is also needed.
Be patient and think of it as a time you can do all those shoulder exercises you never seem to get to.

[mdqs]

mdqs on January 23, 2020 at 9:19 am #36766

Thanks to everyone for the responses — really very helpful. Coincidentally, shortly after posting I ran into an old friend who is now a DPT. He gave things a look and said the abductor hallucis seems weak. When he tensioned it, the discomfort area was pinpointed. Suggested barefoot single-leg work, a lot of emphasis on intrinsic muscles of the foot, and, of course, hip strength / mobility.

Pete, the 2/1, 5/1, 10/2 progression is great. Looking forward to trying that.

[irunovermountains]

irunovermountains on January 23, 2020 at 9:29 am #36769

Hi John,

It certainly sounds like PF to me. I too get the odd ping in this area. It’s always from overuse, but can be managed with regular mobility. I always start the morning with a massage ball on each foot (3-5min) and a coffee, then I move on to foam rolling & other things that work for me.

As previously stated, the problem is coming from somewhere up the chain. For me, the issues are always on my left side and stem from a lack of hip mobility, thanks to 20 years working behind a desk.

Spend time and find your weakness. A physio that specialises in running can do an assessment.

Good luck with your recovery and future adventures.

[thomaszamora8715]

thomaszamora8715 on February 22, 2020 at 4:45 am #38623

I would strongly recommend purchasing a memory foam mattress. My therapist told me that would help and it did for real. I do not understand, speaking frankly, how that works, but when your body is sinking it’s like all your muscles get relaxed. Try something from this list. It’s even better if you’ll find a full set on amazon with memory foam pillow to place them and your arch so the blood will go off, the pressure won’t be so high, and you’ll feel better. That’s my personal experience, though