It has been about 8 months now that I have been dealing with my plantar fasciitis that welcomed itself into my life that one dreadful summer morning. I have been doing everything imaginable for it from icing, rolling, heating, and massage, to dry needling, stretching, strengthening, the Strassburg sock (basically a night splint), toe separators, shoe inserts, and compression sleeves, all with painfully slow improvement, if any. I would take time off of running, solely cross training and rehabbing, then when I felt it was better and would try to run again, I would feel that familiar pain and tightness again in my heel after a few days. I was able to build mileage for a couple weeks at some points, still only to run into the same fate of heel pain once I reached 2-3 weeks of consistency. This would start the cycle over again, forcing me to take another few days off that would turn into weeks and then months.
The good news is that I think I might be reaching the tail end of this injury. Since I got my arm brace off for my broken elbow, I have been given the thumbs up to start running again. This time I have decided to take a slightly different approach. Up until now, I was structuring my return to running in a way that was not working for this injury. I would run for 5-10 minutes every other day, increasing by 5 minutes as long as I felt little to no pain. The first two weeks would always be very cautious and calculated, but then I would get a little too confident and push my foot past it's limits, causing the pain to return, and causing me to have to take more time off again. All tended to go well until I built up to that third or fourth week when the familiar pain and tightness in my heel would welcome itself back into my life. It was frustrating to keep going in circles. In hindsight though, building back up to 50-60 miles in just a few weeks was probably not the best approach for my irritated plantar.
After talking to a couple running friends, one of which is currently working towards his DPT, I settled on a very conservative return to running plan that was recommended to me. The basis of the plan is a very slow progression of walking and running intervals over the course of 5-6 weeks. I was informed that I would hate it and it would feel painfully slow. Eight months into this injury though, I really didn't care. I would take anything at this point. Even the idea of running for a minute at a time had me itching to lace up my running shoes. The plan is split into stages of slowly increasing running intervals and decreasing walking intervals. If at any point I experience pain above a 5/10, I revert back to the previous stage until I can get through 3 days of pain below that level. I have just finished up the second stage of the plan and will be starting the third stage this week (three whole minutes of running intervals!). Each session starts with a walking warm up and ends with a walking cool down, and includes both pre- and post-run exercises and stretching to activate, strengthen, and lengthen the muscles of the and calves and feet. Here is an example of a typical session:
Pre-Run:
- 10-12 x toe-elevated single leg calf raises
- 10-12 x single leg step downs - Stand on a stair or block one one leg, hold the other foot out over the ledge and slowly lower into a small single leg squat until your
heels taps the floor, then rise back up.
- 10-12 x toe spreads and curls
- 10-12 x heel to toe walks (10-12 steps each leg)
- 10-12 x banded glute bridge
- 1-2 x 30 sec deep squat with heels planted
Run/Walk:
- 5 min walking warm up
- 6-10 x (2 min run, 3 min walk)
- 5 minute walking cool down
Post-Run:
- Good calf and plantar stretches!
- Foam roll the calves
- Golf ball massage on the plantar fascia
- Icing the foot if sore
So far my foot has been responding well. Occasionally I feel more of an awareness of the sore spot, not quite a pain, and each time it has come and gone over the course of a few minutes. For an injury like plantar fasciitis, the key is how it feels after running. Thankfully I have not felt any pain post-run which makes me feel I am finally trending in the right direction. The hardest part about this whole progression is staying patient. I want to run normal mileage again so bad, but I know that I need to follow the plan and trust that I will be running again if I am smart about my return. I am reminding myself every day to enjoy the process and stay excited about my small but meaningful achievements of running even one more minute each session. In doing this, I know running will feel even sweeter when I am able to fully return to the sport. In all, I am excited about how everything has been going, and will continue to periodically post updates on my progression!